Silay Emin, Coşkuner İsmail, Yıldız Hüseyin, Bakan Vedat, Baykan Halit, Şenoğlu Nimet, Öksüz Hafize
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey.
Department of Paediatric Surgery, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey.
Turk J Anaesthesiol Reanim. 2013 Oct;41(5):185-7. doi: 10.5152/TJAR.2013.24. Epub 2013 Apr 8.
Cystic hygroma, which originates from embryonic lymphoid tissue, is a benign tumour without any potential for malignancy. It is commonly located in the neck area. Anaesthetic management of a large neck mass may be challenging due to difficulty in intubation and the severe haemodynamic effects of surgical removal of a giant tumour. Serious consequences such as sudden airway occlusion resulting in hypoventilation and hypoxemia may arise. We present the anaesthetic management of a 15-day-old infant who underwent surgical removal of a cystic hygroma located on the left side of the neck. Anaesthesia was induced by mask ventilation with sevoflurane in 100% oxygen and intubation was carried out while maintaining spontaneous ventilation. The endotracheal tube was sutured to the tip of the right lip to avoid movement or extubation. In addition to arterial cannulation for invasive blood pressure monitoring, central venous catheterization for perioperative fluid management was put in place. After 6 hours of surgery, the infant was transported to the neonatal intensive care unit and was extubated without difficulty the next day. Facial nerve injury was observed to be temporary.
淋巴管瘤起源于胚胎淋巴组织，是一种无恶变潜能的良性肿瘤。它通常位于颈部区域。由于插管困难以及手术切除巨大肿瘤时严重的血流动力学影响，对巨大颈部肿块的麻醉管理可能具有挑战性。可能会出现诸如突然气道阻塞导致通气不足和低氧血症等严重后果。我们介绍了一名15天大婴儿的麻醉管理情况，该婴儿接受了位于颈部左侧的淋巴管瘤切除术。麻醉诱导采用面罩通气，吸入100%氧气中的七氟醚，在维持自主通气的同时进行插管。气管内导管缝至右唇角以避免移动或拔管。除了进行动脉穿刺置管用于有创血压监测外，还放置了中心静脉导管用于围手术期液体管理。手术6小时后，婴儿被转运至新生儿重症监护病房，次日顺利拔管。观察到面神经损伤是暂时的。
