Evidence map›Paper›PMID 39171030›Full record

ArticleCureus2024

General Anesthesia for Patients With Cyclic Vomiting Syndrome and Obesity: A Case Report.

Hidetaka Kuroda, Rumi Kaneko, Norika Katagiri, Keita Kagawa, Natsuki Saito, Yoko Sasaki, Kazumi Kuroda-Ohgi, Yukiko Kuroda, Shinsuke Kuroda, Shota Tsukimoto and 3 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Hidetaka KurodaDepartment of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.
Rumi KanekoDepartment of Anesthesiology, Dokkyo Medical University Saitama Medical Center, Saitama, JPN.
Norika KatagiriDepartment of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.
Keita KagawaDepartment of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.
Natsuki SaitoDepartment of Dental Anesthesiology, Tokyo Dental College, Tokyo, JPN.
Yoko SasakiDepartment of Anesthesiology, Saitama Medical University International Medical Center, Saitama, JPN.
Kazumi Kuroda-OhgiProsthodontics, White Dental Clinic, Gunma, JPN.
Yukiko KurodaPediatric Dentistry, White Dental Clinic, Gunma, JPN.
Shinsuke KurodaEndodontics, White Dental Clinic, Gunma, JPN.
Shota TsukimotoDepartment of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.
Noboru IshikawaDepartment of Forensic Odontology and Anthropology, Tokyo Dental College, Tokyo, JPN.
Takahiro AbeDepartment of Oral and Maxillofacial Surgery, Kanagawa Dental University, Kanagawa, JPN.
Takuro SanukiDepartment of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cyclic vomiting syndrome (CVS) is a chronic digestive disorder characterized by recurrent episodes of severe nausea and vomiting. The perioperative management of patients with CVS undergoing general anesthesia is challenging, especially when combined with obesity. This case report describes the successful management of a patient with CVS and obesity who underwent dental surgery under general anesthesia. A 21-year-old woman with CVS, obesity (body mass index, 35), and intellectual disability was scheduled for tooth extraction and composite resin restoration under general anesthesia. The patient was diagnosed with CVS at the age of 20 years with frequent vomiting attacks requiring hospitalization. Surgery was scheduled during the CVS remission to reduce the risk of perioperative vomiting. Preoperative laboratory test results were normal, including serum adrenocorticotropic hormone (ACTH), anti-diuretic hormone (ADH), and cortisol levels. General anesthesia was induced using remifentanil and propofol. Nasal endotracheal intubation was performed after rocuronium administration. Local anesthesia (2% lidocaine with 1:80,000 epinephrine) was used for all dental procedures. Postoperatively, midazolam was administered to control agitation. No postoperative vomiting occurred. Serum ACTH, ADH, and cortisol levels showed no significant changes before and after anesthesia, suggesting that hypothalamic-pituitary-adrenal (HPA) axis activation due to surgical stress did not occur. This case highlights the importance of careful perioperative planning and monitoring stress-related hormone levels in patients with CVS or obesity. An anesthetic approach using midazolam may effectively suppress HPA axis activation and prevent postoperative vomiting.

Indexed as

adrenocorticotropic hormoneanti-diuretic hormonecortisolcyclic vomiting syndromeday surgerydental practicegeneral anesthesiahypothalamic-pituitary-adrenal axisintellectual disabilityobesity

Identifiers

PMID39171030
PMCPMC11338629

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