Stallmer Meghan L, Vanaharam Vishnu, Mashour George A
Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109-0048, USA.
J Clin Anesth. 2008 Sep;20(6):447-51. doi: 10.1016/j.jclinane.2008.04.009.
To determine the ideal airway management modalities in general anesthesia for pediatric patients with Klippel-Feil syndrome, a disorder that is characterized by abnormalities of the cervical spine and craniofacial structures that may impede successful airway management.
Retrospective review of electronic anesthesia database.
University hospital.
The electronic charts of 10 pediatric patients with Klippel-Feil syndrome (KFS) who received treatment at our institution from 2005 to 2007 were reviewed with a focus on diagnosis, level of lesion, comorbid diseases, age, procedure, history of perioperative difficulties, and airway management during general anesthesia.
A total of 10 pediatric patients, 6 girls and 4 boys, underwent 11 procedures from 2005 to 2007. Average age was 11 (range, 4-16 yrs). Six patients were ASA physical status II and 4 were ASA physical status III. Four patients had spinal fusion, 6 underwent magnetic resonance imaging, and one patient underwent removal of halo hardware. Eight patients had undergone previous surgeries; of the 8, one patient had a history of difficult intubation. Six patients underwent tracheal intubations, 4 had a Laryngeal Mask Airway (LMA; Orthovent Intafix, Maidenhead, UK) placed, and one had mask ventilation with an oral airway. Of 6 tracheal intubations, 5 were achieved on the first or second attempt without difficulty. Three had grade 1 laryngoscopic views; only one patient needed fiberoptic intubation. Because the fiberoptic intubation took several attempts, it was noted as a difficult intubation in the chart. All LMAs were placed without difficulty, and the cases were uneventful.
The airways of individuals with KFS may be successfully managed in a variety of ways, often with little degree of difficulty.
确定患有Klippel-Feil综合征的儿科患者在全身麻醉中的理想气道管理方式，该综合征的特征是颈椎和颅面结构异常，可能会妨碍气道管理的成功实施。
对电子麻醉数据库进行回顾性研究。
大学医院。
回顾了2005年至2007年在我院接受治疗的10例患有Klippel-Feil综合征（KFS）的儿科患者的电子病历，重点关注诊断、病变水平、合并疾病、年龄、手术、围手术期困难史以及全身麻醉期间的气道管理。
2005年至2007年，共有10例儿科患者（6名女孩和4名男孩）接受了11次手术。平均年龄为11岁（范围为4至16岁）。6例患者美国麻醉医师协会（ASA）身体状况分级为II级，4例为ASA身体状况分级为III级。4例患者进行了脊柱融合术，6例接受了磁共振成像检查，1例患者接受了头环装置移除术。8例患者曾接受过手术；其中1例有困难插管史。6例患者进行了气管插管，4例置入了喉罩气道（LMA；英国梅登黑德的Orthovent Intafix），1例通过口咽通气道进行面罩通气。在6例气管插管中，5例在首次或第二次尝试时顺利完成。3例喉镜视野为1级；只有1例患者需要纤维支气管镜引导插管。由于纤维支气管镜引导插管进行了多次尝试，病历中记录为困难插管。所有喉罩均顺利置入，手术过程顺利。
KFS患者的气道可以通过多种方式成功管理，通常难度较小。
