Hinohara S, Nakagomi M, Kashimoto S, Kumazawa T, Matsukawa T, Tsuji A
Masui. 1989 Jan;38(1):102-6.
Aortic aneurysm occurs rarely in childhood. Most aneurysms in children are associated with conditions such as Marfan's syndrome, coarctation of the aorta, Ehlers-Danlos syndrome and neurofibromatosis. We report a case of descending thoracic-abdominal aortic aneurysm in an eighteen month old boy with a mask-like face, ocular hypertelorism, blepharoptosis, a high arched palate and low set ears. He was scheduled for a bypass graft of the descending thoracic and abdominal aorta under partial cardiopulmonary bypass. High dose morphine anesthesia (2mg/kg) was employed and halothane was used to control the blood pressure. To our knowledge, anesthetic management of such an infant had not been reported. Therefore, we anesthetized this child according to anesthetic managements for adult cases considering carefully the boy's multiple anomalies. Anesthetic managements for the surgery of aortic aneurysms in childhood are discussed.
主动脉瘤在儿童时期很少见。儿童期的大多数动脉瘤与诸如马方综合征、主动脉缩窄、埃勒斯-当洛综合征和神经纤维瘤病等疾病有关。我们报告一例18个月大男孩的降胸-腹主动脉瘤病例,该男孩面部呈面具样、眼距增宽、上睑下垂、高拱腭及低位耳。他计划在部分体外循环下行降胸和腹主动脉搭桥术。采用了高剂量吗啡麻醉(2mg/kg),并使用氟烷控制血压。据我们所知,此前尚未有对这样一名婴儿进行麻醉管理的报道。因此,我们根据成人病例的麻醉管理方法对该患儿进行麻醉,同时仔细考虑了患儿的多种异常情况。本文讨论了儿童主动脉瘤手术的麻醉管理。