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超声在阿佩尔综合征麻醉管理中的革命性作用:两例报告

The Revolutionary Role of Ultrasound in Anaesthetic Management of Apert Syndrome: A Report of Two Cases.

作者信息

Kanwat Jyoti, Sah Sarita, Das Swati, Jalwal Gopal

机构信息

Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Bathinda, IND.

出版信息

Cureus. 2025 Apr 28;17(4):e83148. doi: 10.7759/cureus.83148. eCollection 2025 Apr.

Abstract

Apert syndrome, a rare congenital disorder characterized by craniosynostosis, syndactyly, and multi-system abnormalities, presents significant challenges in perioperative management. This report delineates the cases of two paediatric patients undergoing orthopaedics and hand surgeries, necessitating meticulous anaesthesia planning. Airway assessment revealed difficult intubation characteristics, necessitating the preparation of advanced airway management tools, including fibreoptic bronchoscopy and bougie-assisted intubation. Ultrasonography played a crucial role in airway evaluation, real-time vascular access, and regional anaesthesia administration. Peripheral and neuraxial blocks were used to optimize analgesia while minimizing opioid-related complications. Intraoperative care focused on maintaining normothermia, ensuring hemodynamic stability, and preventing airway-related morbidity. Extubation was carefully managed following complete neuromuscular recovery. A multidisciplinary approach, incorporating ultrasound-guided interventions, significantly enhanced the safety and efficacy of anaesthetic management. This case report emphasizes the importance of comprehensive preoperative planning and the integration of ultrasonography to mitigate complications and improve perioperative outcomes in patients with Apert syndrome.

摘要

阿佩尔综合征是一种罕见的先天性疾病,其特征为颅缝早闭、并指(趾)畸形和多系统异常,在围手术期管理中面临重大挑战。本报告描述了两名接受骨科和手部手术的儿科患者的病例,这需要精心的麻醉计划。气道评估显示存在困难插管特征,需要准备先进的气道管理工具,包括纤维支气管镜检查和探条引导插管。超声检查在气道评估、实时血管通路建立和区域麻醉给药中发挥了关键作用。使用外周和神经轴阻滞来优化镇痛,同时尽量减少阿片类药物相关并发症。术中护理重点是维持体温正常、确保血流动力学稳定并预防气道相关并发症。在神经肌肉完全恢复后小心进行拔管。采用多学科方法,包括超声引导干预,显著提高了麻醉管理的安全性和有效性。本病例报告强调了全面术前规划以及超声检查整合的重要性,以减轻并发症并改善阿佩尔综合征患者的围手术期结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba8c/12119178/57f1b53fc0e5/cureus-0017-00000083148-i01.jpg

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