Boran Ömer Faruk, Sarıca Selman
Department of Anesthesiology and Reanimation, School of Medicine, Kahramanmaraş Sütçü İmam ÜniversitesiKahramanmarasTurkey.
Department of Otorhinolaryngology, School of Medicine, Kahramanmaraş Sütçü İmam ÜniversitesiKahramanmarasTurkey.
Proc (Bayl Univ Med Cent). 2019 Apr 23;32(2):202-205. doi: 10.1080/08998280.2019.1573630. eCollection 2019 Apr.
In this retrospective study, we reviewed the anesthesia management of patients with choanal atresia (CA). Fourteen patients undergoing surgery for CA between June 2007 and September 2018 were evaluated for age, gender, CA side, complications, American Society of Anesthesiologists score, duration of anesthesia, and presence of any additional anomalies. Six patients (42%) had bilateral atresia, and 8 (58%) had unilateral atresia. Various congenital anomalies were present in 50% of patients with bilateral atresia. Three patients were intubated with a C-MAC D pediatric blade because their Cormack-Lehane grade was 3 or 4. Though sevoflurane was used for all patients, total intravenous anesthesia was used for two patients with unilateral atresia. All patients were followed postoperatively while intubated except one patient with bilateral atresia. There was no need for postoperative intubation of any patients with unilateral atresia. In conclusion, clinicians should be aware of perioperative and postoperative complications in patients with CA, bilateral atresia, and accompanying congenital anomalies in the neonatal period. Total intravenous anesthesia can be chosen instead of inhalation anesthesia in appropriate cases, but sevoflurane can be used safely in the induction of anesthesia.
在这项回顾性研究中,我们回顾了后鼻孔闭锁(CA)患者的麻醉管理情况。对2007年6月至2018年9月期间接受CA手术的14例患者进行了年龄、性别、CA侧别、并发症、美国麻醉医师协会评分、麻醉持续时间以及是否存在任何其他异常情况的评估。6例患者(42%)为双侧闭锁,8例(58%)为单侧闭锁。50%的双侧闭锁患者存在各种先天性异常。3例患者因Cormack-Lehane分级为3级或4级而使用C-MAC D小儿喉镜进行插管。虽然所有患者均使用了七氟醚,但2例单侧闭锁患者采用了全静脉麻醉。除1例双侧闭锁患者外,所有患者术后均在插管状态下接受随访。单侧闭锁患者术后均无需再次插管。总之,临床医生应意识到CA患者、双侧闭锁患者以及新生儿期伴有先天性异常患者的围手术期和术后并发症。在适当情况下可选择全静脉麻醉而非吸入麻醉,但七氟醚可安全用于麻醉诱导。