Erdoğan Mehmet Ali, Sanli Mukadder, Ersoy Mehmet Ozcan
MD; Assistant Anesthesia Professor, Department of Anesthesiology and Reanimation, Inonu University School of Medicine, Malatya, Turkey.
MD; Assistant Anesthesia Professor, Department of Anesthesiology and Reanimation, Inonu University School of Medicine, Malatya, Turkey.
Braz J Anesthesiol. 2013 Jul-Aug;63(4):366-8. doi: 10.1016/j.bjane.2012.07.008. Epub 2013 Aug 13.
Osteogenesis Imperfecta (OI) results from gene mutation that causes defective or insufficient collagen formation. It may cause various anesthetic complications due to the difficulty in airway management, existence of spinal deformity, respiratory disorders, cardiac anomalies, thrombocyte function disorder, risk of hyperthermia, bacillary invagination, bone deformities and metabolic disorders. The anesthesia management of OI patients should be exercised with caution given certain risks of respiratory disorders. These risks are due to thorax deformity, bone fractures during moving or changing position, mandibular and cervical fractures related with intubation, difficult intubation and malignant hyperthermia. The anesthetic technique using Total Intravenous Anesthesia (TIVA) and laryngeal mask airway is suitable for pediatric patient care with OI. However, these techniques have not yet been reported as useful in neurosurgery case reports. In this study, we present the use of TIVA and ProSeal Laringeal Mask in a child with OI and epidural hemorrhage. We came to the conclusion that LMA and TIVA can safely be used in the anesthetic management of OI patients with severe anesthetic problems.
成骨不全症（OI）由基因突变导致胶原蛋白形成缺陷或不足引起。由于气道管理困难、存在脊柱畸形、呼吸障碍、心脏异常、血小板功能障碍、体温过高风险、细菌内陷、骨骼畸形和代谢紊乱，它可能导致各种麻醉并发症。鉴于存在呼吸障碍的某些风险，对OI患者的麻醉管理应谨慎进行。这些风险归因于胸廓畸形、移动或改变体位时的骨折、与插管相关的下颌骨和颈椎骨折、插管困难以及恶性高热。使用全静脉麻醉（TIVA）和喉罩气道的麻醉技术适用于OI患儿的护理。然而，在神经外科病例报告中，这些技术尚未被报道有用。在本研究中，我们展示了TIVA和ProSeal喉罩在一名患有OI和硬膜外出血的儿童中的应用。我们得出结论，喉罩和TIVA可安全用于存在严重麻醉问题的OI患者的麻醉管理。
