Sugino Shigekazu, Kanaya Noriaki, Omote Keiichi, Namiki Akiyoshi
Department of Anesthesiology, Sapporo Medical University School of Medicine.
Masui. 2005 Dec;54(12):1367-70.
A 5-year-old girl with Goldenhar's syndrome was scheduled for reconstruction of her left thumb. Because her preanesthetic X-p had revealed airway abnormality, difficult intubation was anticipated. After induction of anesthesia with thiamylal, the lungs were ventilated easily via a facemask. A perilaryngeal airway (PLA) was inserted after obtaining adequate depth of anesthesia with sevoflurane. Anesthesia was maintained with sevoflurane (2%) plus nitrous oxide (66%) under spontaneous ventilation. The operation was finished uneventfully. However, a re-operation was scheduled for postoperative hemorrhage on that day. In consideration of potential regurgitation of gastric content, endotracheal intubation was scheduled. Her vocal cord was confirmed with a videolaryngoscope, and she was intubated successfully. In conclusion, a PLA and a videolaryngoscope are useful for airway management of patients with Goldenhar's syndrome for whom difficulty in intubation is anticipated.
一名患有Goldenhar综合征的5岁女孩计划进行左手拇指重建手术。由于其麻醉前的X线片显示气道异常，预计插管困难。用硫喷妥钠诱导麻醉后，通过面罩可轻松进行肺通气。在用七氟醚达到足够的麻醉深度后插入喉周气道（PLA）。在自主通气下用七氟醚（2%）加氧化亚氮（66%）维持麻醉。手术顺利完成。然而，当天因术后出血安排了再次手术。考虑到胃内容物可能反流，安排了气管插管。用视频喉镜确认了她的声带，并成功进行了插管。总之，PLA和视频喉镜对于预计插管困难的Goldenhar综合征患者的气道管理很有用。
