Total Intravenous Anesthesia for a Patient with Narcolepsy - Abstract
We report the successful management of Total Intravenous Anesthesia (TIVA) for a narcoleptic patient using propofol and remifentanil under Bispectral Index (BIS) monitoring. A 63-year-old woman with narcolepsy required oral surgery under general anesthesia. On the morning of the day of operation, she took methylphenidate and modafinilfor control of narcolepsy. Anesthesia was induced with continuous infusion
of remifentanil and propofol, and maintained with remifentanil and propofol under BIS monitoring. Anesthesia, which lasted almost 4.5 h, was uneventful, with neither significant change in hemodynamics nor delayed emergence from anesthesia. In our patient, symptoms of narcolepsy were well controlled. In such patients, habitual central nervous system stimulants should be continued before anesthesia, and short-acting anesthetic drugs are desirable for general anesthesia.