Kamarkar U S, Chaudhari L S, Hosalkar H, Budhi M, Venkataraghavan D
Department of Anaesthesia and Orthopaedics, Seth G.S. Medical College, Mumbai.
J Postgrad Med. 1998 Apr-Jun;44(2):43-6.
A case of severe ankylosing spondylitis involving the entire spine was to be operated for lumbar osteotomy. She had fixed rigidity of the cervical spine with minimal rotational movement, inability to lie down supine and severe restrictive lung disease with hypoxemia (pO2 = 65 mmHg). An awake intubation was performed and the patient was operated under general anaesthesia in the prone position. Intraoperative "wake-up" test was performed to judge whether extent of straightening was excessive. Postoperatively, she was electively ventilated and extubated uneventfully after 24 hours.
一名患有累及整个脊柱的严重强直性脊柱炎患者拟行腰椎截骨术。她颈椎固定僵硬，旋转活动极少，无法仰卧，并有严重的限制性肺病伴低氧血症（动脉血氧分压 = 65 mmHg）。遂进行清醒插管，患者在全身麻醉下俯卧位接受手术。术中进行“唤醒”试验以判断矫直程度是否过度。术后，她接受选择性通气，24小时后顺利拔管。
