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全身麻醉用于治疗先天性肌无力综合征合并脊柱侧弯:一例病例报告。

General anesthesia for treating scoliosis with congenital myasthenia syndrome: a case report.

作者信息

Yamashita Atsushi, Muramatsu Yuka, Matsuda Hiromi, Okamoto Hirotsugu

机构信息

Department of Anesthesia, Kitasato University School of Mediceine, 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0375, Japan.

出版信息

JA Clin Rep. 2022 Aug 31;8(1):70. doi: 10.1186/s40981-022-00560-1.

DOI:10.1186/s40981-022-00560-1
PMID:36044129
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9433483/
Abstract

BACKGROUND

Congenital myasthenia syndrome is a heterogeneous disease with impaired neuromuscular transmission.

CASE PRESENTATION

This report describes a 13-year-old child with congenital myasthenia syndrome who underwent surgery for scoliosis under general anesthesia. We used a small dose of rocuronium, neuromuscular transmission monitoring, and non-invasive positive pressure ventilation for postoperative respiratory management. There were no respiratory complications during the perioperative period.

CONCLUSION

As there are only a few reports on the anesthetic management of patients with congenital myasthenia syndrome, we applied the principles of managing autoimmune myasthenia gravis. The postoperative management described herein can prevent respiratory complications in patients with congenital myasthenia syndrome.

摘要

背景

先天性肌无力综合征是一种神经肌肉传递受损的异质性疾病。

病例报告

本报告描述了一名患有先天性肌无力综合征的13岁儿童,其在全身麻醉下接受了脊柱侧弯手术。我们使用了小剂量罗库溴铵、神经肌肉传递监测,并采用无创正压通气进行术后呼吸管理。围手术期未出现呼吸并发症。

结论

由于关于先天性肌无力综合征患者麻醉管理的报道较少,我们应用了自身免疫性重症肌无力的管理原则。本文所述的术后管理可预防先天性肌无力综合征患者的呼吸并发症。

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本文引用的文献

1
Congenital Myasthenic Syndromes.先天性肌无力综合征
Neurol Clin. 2020 Aug;38(3):541-552. doi: 10.1016/j.ncl.2020.03.004.
2
Comparison of the effects of oxycodone versus fentanyl on airway reflex to tracheal extubation and postoperative pain during anesthesia recovery after laparoscopic cholecystectomy: A double-blind, randomized clinical consort study.羟考酮与芬太尼对腹腔镜胆囊切除术后麻醉恢复期间气管拔管气道反射及术后疼痛影响的比较:一项双盲、随机临床联合研究。
Medicine (Baltimore). 2018 Mar;97(13):e0156. doi: 10.1097/MD.0000000000010156.
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[Anesthetic management of scoliosis surgery for a patient with congenital myasthenic syndrome].[先天性肌无力综合征患者脊柱侧弯手术的麻醉管理]
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Anesthesia and myasthenia gravis.麻醉与重症肌无力。
Acta Anaesthesiol Scand. 2012 Jan;56(1):17-22. doi: 10.1111/j.1399-6576.2011.02558.x. Epub 2011 Oct 19.
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Caudal epidural anesthesia for a 2-year old child with congenital myasthenia gravis.对一名患有先天性重症肌无力的2岁儿童进行骶管硬膜外麻醉。
Agri. 2008 Oct;20(4):49-52.
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Inherited disorders of the neuromuscular junction.神经肌肉接头的遗传性疾病。
Int Anesthesiol Clin. 2006 Spring;44(2):91-106. doi: 10.1097/00004311-200604420-00006.
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Isoflurane for sedation in a case of congenital myasthenia gravis.异氟烷用于一例先天性重症肌无力患者的镇静。
Br J Anaesth. 1996 Nov;77(5):672-4. doi: 10.1093/bja/77.5.672.