Gibbins M, Quader K, Watson G, Pichierri A
Anaesthesia and Intensive Care Medicine Severn Deanery Bristol UK.
Southmead Hospital Bristol UK.
Anaesth Rep. 2020 May 14;8(1):32-35. doi: 10.1002/anr3.12039. eCollection 2020 Jan-Jun.
For patients with epilepsy refractory to medical management, vagal nerve stimulator implantation may reduce the number of seizures and/or reduce their severity. A 34-year-old woman with epilepsy underwent a change in vagal nerve stimulator battery under general anaesthesia with a supraglottic airway device and total intravenous anaesthesia. During the procedure, she developed clinically significant airway obstruction, which resolved only when the device was disabled. We recommend that anaesthetists and others providing peri-operative care for patients with a vagal nerve stimulator remain vigilant to the possibility of device-related airway obstruction, which may occur even in asymptomatic patients. All patients with a vagal nerve stimulator are provided with a magnet that will disable the device, should complications arise. There is a need to establish a standard approach to the peri-operative care of these patients, including the identification and management of device-related airway obstruction.
对于药物治疗难治性癫痫患者，植入迷走神经刺激器可能会减少癫痫发作次数和/或减轻发作严重程度。一名34岁的癫痫女性患者在使用声门上气道装置和全静脉麻醉的全身麻醉下更换了迷走神经刺激器电池。手术过程中，她出现了具有临床意义的气道梗阻，仅在设备停用后才得以缓解。我们建议，为植入迷走神经刺激器的患者提供围手术期护理的麻醉医生及其他人员，要对与设备相关的气道梗阻可能性保持警惕，即使是无症状患者也可能发生这种情况。所有植入迷走神经刺激器的患者都配有一块磁铁，一旦出现并发症，可使设备停用。有必要建立针对这些患者围手术期护理的标准方法，包括识别和处理与设备相关的气道梗阻。
