thiamylal and Glaucoma

We gave anesthesia 4 times to a patient (19-year-old female) with allergic granulomatous angitis (AGA). She had asthma, myopathy and detrimental side effect in her eyes of steroid therapy for AGA. Two of the 4 operations were emergency laparotomy for peritonitis due to colon perforation, and the other 2 operations were elective eye surgeries. General anesthesia was induced with thiamylal (1st operation) or midazolam (2nd-4th operation). Intraoperative anesthesia was maintained with N2O-O2-isoflurane combined with thoracic epidural anesthesia (1st operation) or N2O-O2-sevoflurane (2nd-4th operation). Asthmatic attack, which AGA accompanies frequently, did not occur during these anesthetic managements. The steroid therapy, which is a fundamental means to control the allergic syndrome, might suppress asthma. However, asthmatic attack and systemic vasculitis should be kept in mind in anesthetic management of AGA.

Topics: Adolescent; Anesthesia, Epidural; Anesthesia, General; Anesthetics, Combined; Anesthetics, Inhalation; Anesthetics, Intravenous; Churg-Strauss Syndrome; Elective Surgical Procedures; Female; Glaucoma; Humans; Isoflurane; Methyl Ethers; Midazolam; Nitrous Oxide; Perioperative Care; Sevoflurane; Thiamylal