Anesthesia and postoperative management of a patient with Gilbert's syndrome and one with Dubin-Johnson syndrome is reported. The former patient underwent open heart surgery and the latter had a partial resection and reconstruction of the esophagus. The anesthetics used in these two cases were fentanyl and nitrous oxide. The patient with Gilbert's syndrome had remarkable perioperative complications. On the other hand, the patient with Dubin-Johnson syndrome developed conjugated hyperbilirubinemia after the 2nd postoperative day. On the 5th postoperative day, his serum and direct bilirubin levels were elevated to 19.3 mg.dl-1 and 12.8 mg.dl-1, respectively. Therefore, we had to perform daily plasmapheresis on this patient for four days. Thereafter, his serum bilirubin level decreased gradually.
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