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七氟醚吸入诱导麻醉期间,一名喉乳头状瘤病儿科患者的气道损失:病例报告

Airway loss during inhalation induction of anesthesia with sevoflurane in a pediatric patient with laryngeal papillomatosis: A case report.

作者信息

Hu Xiao, Shen Xia

机构信息

Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, Shanghai 200031, P.R. China.

出版信息

Exp Ther Med. 2015 Dec;10(6):2429-2431. doi: 10.3892/etm.2015.2805. Epub 2015 Oct 15.

Abstract

The aim of the present study was to report a failed inhalation induction of anesthesia with sevofluran in a pediatric patient with grade III laryngeal obstruction caused by laryngeal papillomatosis. Inhalation induction is recommended for the induction of anesthesia in pediatric patients. In the present case, due to the respiratory depression properties of the anesthetics, the partial airway obstruction developed into complete airway obstruction, followed by cardiac arrest. The patient survived after the surgeon managed to reconvert the complete airway obstruction into partial airway obstruction through the removal of part of the laryngeal papillomas. In conclusion, the reaction of the patient in the present case to sevoflurane inhalation induction suggests that this technique is not recommended for patients with pre-existing severe airway obstruction. In such cases, special consideration and preparation is required.

摘要

本研究的目的是报告一例因喉乳头状瘤导致Ⅲ级喉梗阻的儿科患者,七氟醚吸入诱导麻醉失败的病例。对于儿科患者,推荐采用吸入诱导麻醉。在本病例中,由于麻醉药的呼吸抑制特性,部分气道梗阻发展为完全气道梗阻,随后发生心脏骤停。在外科医生通过切除部分喉乳头状瘤,成功将完全气道梗阻转为部分气道梗阻后,患者得以存活。总之,本病例中患者对七氟醚吸入诱导的反应表明,对于已有严重气道梗阻的患者,不推荐使用该技术。在此类病例中,需要特别考虑并做好准备。

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Paediatric anaesthesia and inhalation agents.小儿麻醉与吸入性麻醉药
Best Pract Res Clin Anaesthesiol. 2005 Sep;19(3):501-22. doi: 10.1016/j.bpa.2005.01.001.
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National registry for juvenile-onset recurrent respiratory papillomatosis.青少年复发性呼吸道乳头状瘤病国家登记处
Arch Otolaryngol Head Neck Surg. 2003 Sep;129(9):976-82. doi: 10.1001/archotol.129.9.976.
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Task force on recurrent respiratory papillomas. A preliminary report.
Arch Otolaryngol Head Neck Surg. 1995 Dec;121(12):1386-91. doi: 10.1001/archotol.1995.01890120044008.

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