Propofol anesthesia for a schizophrenic patient
Sakaguchi, H.; Taguchi, H.; Ushijima, K.
Masui. Japanese Journal of Anesthesiology 46(8): 1127-1129
1997
ISSN/ISBN: 0021-4892 PMID: 9283174 Document Number: 477538
A 41-year-old man weighing 68 kg was scheduled for bilateral tonsillectomy because of palmoplantar pustulosis. The patient had been diagnosed as schizophrenic 10 years earlier. Psychotropic agents, mosapramine (75 mg cntdot day-1), bromperidol (6 mg cntdot day-1), cloxazolam (3 mg cntdot day-1), biperiden (1 mg cntdot day-1) and nitrazepam (5 mg as needed), were administered until the day before surgery. On the day of surgery, atropine (0.5 mg) and midazolam (4 mg) were administered intramuscularly as premedication. Anesthesia was induced by intravenous propofol (120 mg) and fentanyl (100 mu-g) followed by nasotracheal intubation using vecuronium (7 mg). Anesthesia was maintained with the inhalation of oxygen and nitrous oxide (2 l cntdot min-1 each) and the intravenous infusion of propofol (5-10 mg cntdot kg-1 cntdot h-1) supplemented by fentanyl (100 mu-g). The patient recovered from anesthesia uneventfully. Immediately after surgery, intravenous haloperidol (5 mg) and intramuscular biperiden (1 mg) were given. The daily oral administration of psychotropics was resumed on the first postoperative day. There were no complications such as hypotension, arrhythmia, or worsening of the mental condition, throughout the course.