[Anesthetic Management of a Patient with Rett Syndrome Presenting Severe Breath Holding and Massive Aerophagia].

Abstract

We anesthetized a patient with Rett syndrome pre- senting intense breath holdings and severe aerophagia for dental treatment The patient had shown an intense breath holding plunging into hypoxia during slow induction with sevoflurane in previous anesthesias. Therefore, we chose rapid sequence induction with intravenous propofol and rocuronium and intubated orally. The length of glottis to tracheal bifurcation was shorter than average patient After a gastric tube was inserted and the content was aspirated, the orotracheal tube was changed to nasotracheal one. When she recovered from anesthesia at the quite deep stage, her saliva poured from nose and orally and began severe aerophagia. Once again, deep depth of anesthesia was kept, and we minimized stimulations for her. By. this approach, anesthesia was achieved uneventfully. In this case, she had signs of early-awakening from anesthesia.