Anesthesia Management in Rare Case: Osteogenesis Imperfecta

A. Karaveli, N. Ozturk, A. S. Kavakli, G. Çakmak, A. A. Onuk, K. İnanoğlu, B. Karsli
{"title":"Anesthesia Management in Rare Case: Osteogenesis Imperfecta","authors":"A. Karaveli, N. Ozturk, A. S. Kavakli, G. Çakmak, A. A. Onuk, K. İnanoğlu, B. Karsli","doi":"10.9734/BJPR/2017/31703","DOIUrl":null,"url":null,"abstract":"Osteogenesis imperfecta is a rare genetic disorder and a collagen tissue disease for which preoperative preparation and intra-operative anesthesia management must be performed with great care on patients. An operation was planned for a 5-year old female patient with Type I osteogenesis imperfecta due to a right femoral fracture. Her medical history showed that she had been operated due to a left femoral fracture 5 months ago under sevoflurane inhalation anesthesia without any complications. On her physical examination, she was observed to be a short child with growth deficiency, kyphoscoliosis, and bone and shape deformities on her extremities. Her modified Mallampati score was III and neck extension was limited. Preoperative echocardiography, complete blood cell count, coagulation profile, and biochemical values were found in normal limits. She was taken into the Case Study Karaveli et al.; BJPR, 15(5): 1-5, 2017; Article no.BJPR.31703 2 operation theatre and monitorized. Pressure points were supported by silicon peds. Vascular access could not be established at first because of her agitation, and then it was achieved after the patient’s anesthesia induction was performed with sevoflurane. Her neck was kept stable and laryngeal mask was placed in the mouth in the first intervention. Anesthesia was provided through 50% O2 + 50% air and 2% sevoflurane. At the end of the operation that took 90 min, the patient was extubated unevenBtfully, and taken to the recovery room. Main anesthetic problems in patients with osteogenesis imperfecta are the difficulties in maintaining the airway management and malign hyperthermia. We used sevoflurane both at the induction and at the maintenance of anaesthesia due to the difficult vascular access of the patient, and we did not encounter any problems. Inhalation anesthesia such as sevoflurane as well as TIVA could be used for the anesthesia for the patients with osteogenesis imperfecta. Great care must be given because of difficult airway in such patients, and necessary precautions must be taken. Laryngeal mask airway could be preferred in order to secure the airway and avoid traumatic complications.","PeriodicalId":9320,"journal":{"name":"British journal of pharmaceutical research","volume":"56 1","pages":"1-5"},"PeriodicalIF":0.0000,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British journal of pharmaceutical research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.9734/BJPR/2017/31703","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1

Abstract

Osteogenesis imperfecta is a rare genetic disorder and a collagen tissue disease for which preoperative preparation and intra-operative anesthesia management must be performed with great care on patients. An operation was planned for a 5-year old female patient with Type I osteogenesis imperfecta due to a right femoral fracture. Her medical history showed that she had been operated due to a left femoral fracture 5 months ago under sevoflurane inhalation anesthesia without any complications. On her physical examination, she was observed to be a short child with growth deficiency, kyphoscoliosis, and bone and shape deformities on her extremities. Her modified Mallampati score was III and neck extension was limited. Preoperative echocardiography, complete blood cell count, coagulation profile, and biochemical values were found in normal limits. She was taken into the Case Study Karaveli et al.; BJPR, 15(5): 1-5, 2017; Article no.BJPR.31703 2 operation theatre and monitorized. Pressure points were supported by silicon peds. Vascular access could not be established at first because of her agitation, and then it was achieved after the patient’s anesthesia induction was performed with sevoflurane. Her neck was kept stable and laryngeal mask was placed in the mouth in the first intervention. Anesthesia was provided through 50% O2 + 50% air and 2% sevoflurane. At the end of the operation that took 90 min, the patient was extubated unevenBtfully, and taken to the recovery room. Main anesthetic problems in patients with osteogenesis imperfecta are the difficulties in maintaining the airway management and malign hyperthermia. We used sevoflurane both at the induction and at the maintenance of anaesthesia due to the difficult vascular access of the patient, and we did not encounter any problems. Inhalation anesthesia such as sevoflurane as well as TIVA could be used for the anesthesia for the patients with osteogenesis imperfecta. Great care must be given because of difficult airway in such patients, and necessary precautions must be taken. Laryngeal mask airway could be preferred in order to secure the airway and avoid traumatic complications.
罕见病例成骨不全的麻醉处理
成骨不全症是一种罕见的遗传性疾病和胶原组织疾病,患者术前准备和术中麻醉管理必须非常小心。我们计划对一名5岁女性患者进行手术治疗,该患者因右侧股骨骨折导致I型成骨不全。病史显示5个月前因左股骨折行七氟烷吸入麻醉手术,无并发症。在体格检查中,她被观察到是一个矮小的孩子,有生长缺陷,脊柱后凸,四肢骨骼和形状畸形。改良Mallampati评分为III,颈部伸展受限。术前超声心动图、全血细胞计数、凝血特征和生化指标均在正常范围内。她被纳入Karaveli等人的案例研究;生物工程学报,15(5):1-5,2017;文章no.BJPR。31703 2手术室和监控。压力点由硅电极支撑。由于患者的躁动,最初无法建立血管通路,在七氟醚麻醉诱导后才得以建立。在第一次干预中保持颈部稳定,并在口腔内放置喉罩。麻醉通过50% O2 + 50%空气和2%七氟醚提供。手术持续了90分钟,手术结束后,患者顺利拔管,并被送往恢复室。成骨不全患者的主要麻醉问题是维持气道管理的困难和恶性高热。由于患者血管进出困难,我们在诱导和维持麻醉时都使用了七氟醚,没有遇到任何问题。成骨不全患者可采用七氟醚等吸入麻醉和TIVA麻醉。由于这类患者呼吸道困难,必须非常小心,并采取必要的预防措施。为了保证气道的安全,避免外伤性并发症的发生,首选喉罩气道。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信