[A case of hyperemia during arteriovenous malformation surgery controlled with beta-blocker and jugular bulb oxygen saturation (SjO2) monitoring].

The authors report a case of hyperemic complications during arteriovenous malformation (AVM) surgery controlled with beta-blocker. A 25-year-old male was anesthetized with propofol-fentanyl under jugular venous bulb oxygen saturation (SjO2) monitoring. Just after the total removal of AVM, SjO2 and blood pressure increased suddenly and brain swelling occurred. On the diagnosis of hyperemia of the brain, hyperventilation and controlled hypotension with nicardipine, diltiazem and sodium nitroprusside were started, but they were not effective. Thereafter, we injected a beta-blocker (propranolol, 0.2 mg) intravenously, resulting in the decrease in blood pressure and the disappearance of the brain swelling. SjO2 monitoring supports the safe management of postresection hyperemia, and beta-blocker can be useful against hyperemic complications during and after AVM surgery.