Sen Sreyashi, Mitra Koel, Ganguli Shanta, Mukherji Sudakshina
Department of Anaesthesiology, Medical College, Kolkata, West Bengal, India.
Anesth Essays Res. 2018 Jan-Mar;12(1):288-290. doi: 10.4103/0259-1162.172336.
Haemophilia is an inherited bleeding disorder with variable deficiency of Factor VIII in the plasma and is characterised by bleeding into joints, muscles and tissues either spontaneously or in response to trivial trauma. Perioperative care requires multidisciplinary involvement. Perioperative management involves the risk of excessive bleeding from surgical site as well as spontaneous bleeding into the brain in response to surgical stress in patients with previous history of intracerebral haemorrhage. Airway management of such patients during anaesthetic intervention is a challenge and entails the risk of life threatening haemorrhage into the airway. The I gel Supraglottic airway device may be best suited for the purpose considering its soft elastomeric non-inflatable cuff, ease of insertion, availability of gastric suction port and minimal leak fraction on controlled ventilation. The I Gel may be solution to avoiding airway instrumentation in patients with bleeding disorders. It may be an alternative to endotracheal intubation in patients with Haemophilia undergoing surgery.
血友病是一种遗传性出血性疾病，血浆中因子VIII缺乏程度各异，其特征是关节、肌肉和组织自发出血或因轻微创伤而出血。围手术期护理需要多学科参与。围手术期管理涉及手术部位过度出血的风险，以及有脑出血病史的患者因手术应激而发生自发性脑内出血的风险。在麻醉干预期间，对此类患者进行气道管理具有挑战性，并且存在气道内危及生命的出血风险。考虑到I gel喉上气道装置的软质弹性非充气袖带、易于插入、有胃吸引口以及控制通气时漏气率极低，它可能最适合这一用途。I Gel可能是避免对出血性疾病患者进行气道器械操作的解决方案。它可能是血友病患者手术时气管插管的替代方法。
