马拉维一名法洛四联症未修复的患儿行唇裂麻醉管理：病例报告。
Anaesthesia management for cleft lip in a child with unrepaired Tetralogy of Fallot in Malawi: a case report.
机构信息
Mercy James Centre for Paediatric Surgery and Intensive Care, Queen Elizabeth Central Hospital, Blantyre, Malawi.
Faculty of Medicine, Univesité Catholique du Graben de Butembo, Democratic Republic of Congo.
出版信息
Malawi Med J. 2022 Sep;34(3):201-203. doi: 10.4314/mmj.v34i3.9.
BACKGROUND
Children with clefts lips often present with cardiac abnormalities, among them the tetralogy of Fallot. Anaesthesia for patients with unrepaired Tetralogy of Fallot coming for a non-cardiac surgery represents an additional risk of increased perioperative morbidity and mortality.
CASE PRESENTATION
We present a case of a 8 years old boy with unrepaired Tetralogy of Fallot scheduled for cleft lip repair. The Child was referred to Mercy James Centre for Paediatric Surgery and Intensive Care from an Operation Smile Mission campaign. Anaesthesia consisted of a balanced general anaesthesia combined with regional anaesthesia by an infraorbital nerve block. The child developed hypercyanotic spells postoperatively which were successfully managed with noradrenaline, morphine, fluid, and oxygen therapy.
CONCLUSION
Children with unrepair Tetralogy of Fallot coming for non-cardiac surgery have increased risk of complications during anaesthesia. The anaesthesia provider should be aware and ready to manage them promptly.
背景
唇裂患儿常伴有心脏异常，其中包括法洛四联症。未修复的法洛四联症患者行非心脏手术的麻醉存在增加围手术期发病率和死亡率的风险。
病例介绍
我们介绍了一例 8 岁男孩，患有未修复的法洛四联症，拟行唇裂修复术。该患儿由微笑行动医疗队转介至 Mercy James 儿科外科和重症监护中心。麻醉采用平衡全身麻醉联合眶下神经阻滞的区域麻醉。患儿术后出现高氰血症发作，经去甲肾上腺素、吗啡、液体和氧气治疗后成功控制。
结论
未修复的法洛四联症患儿行非心脏手术的麻醉存在增加并发症的风险。麻醉提供者应意识到并准备迅速处理这些并发症。
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