Miao Ning, Lu Xiaowei, O'Grady Naomi P, Yanjanin Nicole, Porter Forbes D, Quezado Zenaide M N
Department of Perioperative Medicine, National Institutes of Health Clinical Center, Bethesda, MD, USA.
J Child Neurol. 2012 Dec;27(12):1541-6. doi: 10.1177/0883073812437243. Epub 2012 Feb 28.
Niemann-Pick disease type C, an autosomal recessive lysosomal storage disorder, can present with severe visceral and neurologic involvement and is associated with a significant decrease in life expectancy. As little is known about anesthetic considerations of this disease, we examined the perianesthetic course of patients with Niemann-Pick disease type C. Thirty-two patients with Niemann-Pick disease type C, median age 6.9 years (1.8-33 years), underwent 64 general anesthetics for diagnostic procedures. Perianesthetic morbidity included need for tracheal reintubation, pneumonitis, hypothermia, and seizure. Therefore, Niemann-Pick disease type C-associated neurologic and visceral involvement might have anesthetic implications that neurologists and pediatricians should be aware of and consider discussing with parents, guardians, and the patient's care team when procedures requiring anesthesia are planned. Furthermore, it is important for delivery of safe anesthesia that there is communication among care team members so that all involved understand the disease manifestation spectrum.
C型尼曼-匹克病是一种常染色体隐性溶酶体贮积症,可出现严重的内脏和神经受累,并与预期寿命显著缩短有关。由于对该疾病的麻醉注意事项知之甚少,我们研究了C型尼曼-匹克病患者的围麻醉期过程。32例C型尼曼-匹克病患者,中位年龄6.9岁(1.8 - 33岁),接受了64次用于诊断程序的全身麻醉。围麻醉期并发症包括需要再次气管插管、肺炎、体温过低和癫痫发作。因此,C型尼曼-匹克病相关的神经和内脏受累可能具有麻醉方面的影响,神经科医生和儿科医生应该意识到这一点,并在计划进行需要麻醉的手术时考虑与家长、监护人及患者的护理团队进行讨论。此外,护理团队成员之间进行沟通非常重要,以便所有相关人员了解疾病的表现范围,从而确保安全麻醉的实施。