Colizza A, Bellucci R, di Stadio A, Ingravalle A, Buonopane C, Ralli M, de Vincentiis M
Department of Sense Organs, Sapienza University of Rome, Italy.
Department of Anesthesiology, Critical Care and Pain Medicine, Sapienza University of Rome, Italy.
Clin Ter. 2022 Nov-Dec;173(6):503-506. doi: 10.7417/CT.2022.2470.
Kennedy's disease (KD) is a rare X-linked recessive motor-neuron neuropathy also known as Spinal and Bulbar Muscular Atrophy (SBMA).
We report a case of Kennedy's disease (KD) with acute laryngeal stridor and dysphagia whose anesthesiologic management required a tracheotomy. The surgical procedure was conducted under local anesthesia performed by ultrasound-guided superior laryngeal nerve block and superficial cervical plexus block using 2% lidocaine. The surgical procedure was well tolerated without any discomfort reported from the patient.
In KD local anesthesia should be preferred to general anesthesia as general anesthesia is associated with increased potential for laryngospasm, pulmonary aspiration, and respiratory insufficiency related to the use of neuromuscular blocking agents and opioids. At the best of our knowledge, this is the first case of tracheostomy in KD patient under locoregional anesthesia performed thorough superior laryngeal nerve and superficial cervical plexus block.
肯尼迪病（KD）是一种罕见的X连锁隐性运动神经元神经病，也称为脊髓和延髓肌萎缩症（SBMA）。
我们报告一例患有急性喉喘鸣和吞咽困难的肯尼迪病（KD）病例，其麻醉管理需要进行气管切开术。手术在局部麻醉下进行，采用超声引导下的喉上神经阻滞和颈浅丛阻滞，使用2%利多卡因。手术过程患者耐受性良好，未报告任何不适。
在肯尼迪病中，应首选局部麻醉而非全身麻醉，因为全身麻醉与喉痉挛、肺误吸以及与使用神经肌肉阻滞剂和阿片类药物相关的呼吸功能不全的可能性增加有关。据我们所知，这是首例在局部区域麻醉下通过喉上神经和颈浅丛阻滞对肯尼迪病患者进行气管切开术的病例。
