疑似神经肌肉疾病婴儿肌肉活检的脊髓麻醉：一例报告
Spinal anesthesia for muscle biopsy in an infant with a suspected neuromuscular disorder: a case report.
作者信息
Ishida Yoshiaki, Morita Masato, Sasaki Takahisa, Taniguchi Akiko
机构信息
Department of Anesthesiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu-shi, Shizuoka, 430-8558, Japan.
Department of Anesthesiology, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo-shi, Aichi, 446-8602, Japan.
出版信息
JA Clin Rep. 2020 Oct 19;6(1):84. doi: 10.1186/s40981-020-00392-x.
BACKGROUND
Neuromuscular disorders (NMDs) occur in different forms and are generally diagnosed using muscle biopsy. Among the available anesthetic management options for infants with a suspected NMD are general anesthesia (GA) and regional anesthesia (RA), including spinal anesthesia (SA). Anesthesia selection is often challenging from the point of potential airway risks and anesthetic drug-related complications.
CASE PRESENTATION
A 6-month-old male infant repeatedly underwent endotracheal intubation and extubation after birth because of respiratory muscle weakness and copious secretions. He was suspected of having NMD and was scheduled for muscle biopsy. His generalized hypotonia and decreased respiratory function presented a potentially difficult airway and complicated the selection of an appropriate anesthetic method. We selected SA and dexmedetomidine, which are safe for infants.
CONCLUSION
We report the successful and effective anesthetic management of SA and dexmedetomidine in an infant with a suspected NMD.
背景
神经肌肉疾病（NMDs）有不同的表现形式，通常通过肌肉活检进行诊断。对于疑似患有NMD的婴儿，现有的麻醉管理选择包括全身麻醉（GA）和区域麻醉（RA），其中区域麻醉包括脊髓麻醉（SA）。从潜在气道风险和麻醉药物相关并发症的角度来看，麻醉方式的选择往往具有挑战性。
病例介绍
一名6个月大的男婴出生后因呼吸肌无力和大量分泌物反复接受气管插管和拔管。他被怀疑患有NMD，并计划进行肌肉活检。他的全身肌张力减退和呼吸功能下降提示气道可能存在困难，这使得选择合适的麻醉方法变得复杂。我们选择了对婴儿安全的脊髓麻醉和右美托咪定。
结论
我们报告了在一名疑似患有NMD的婴儿中成功且有效地使用脊髓麻醉和右美托咪定进行麻醉管理的案例。
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