Anaesthesia in an adult with Rubenstein-Taybi syndrome using the ProSeal laryngeal mask airway

Twigg, Steven; Cook, Tim

doi:10.1093/bja/89.5.786

Cited by 24 publications

(18 citation statements)

References 11 publications

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“…Also the ILMA, designed especially for the management of the difficult airway, has been described as being successfully used for ventilation in the anticipated [26][27][28][29][30][31][32] and unanticipated [33,34] difficult airway in 97-100% of cases. Case reports or series (level 4) of successful ventilation in patients with difficult airways have been described for many other SADs: the LMA PLMA [35][36][37][38][39][40][41], the SLMA [42][43][44], the i-gel [45][46][47][48][49][50], the Ambu-i TM [51], the Air-Q [52][53][54][55], the CobraPLA [56] and the CobraPLUS [57]. The Laryngeal Tube, designed for emergency ventilation, is also successfully described in difficult airway management in elective adult [58] and paediatric [59] patients in the operation room.…”

Section: Ventilation Via Different Sads In a Difficult To Manage Airwaymentioning

confidence: 99%

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Timmermann

2011

Anaesthesia

167

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SummarySupraglottic airway devices (SAD) play an important role in the management of patients with difficult airways. Unlike other alternatives to standard tracheal intubation, e.g. videolaryngoscopy or intubation stylets, they enable ventilation even in patients with difficult facemask ventilation and simultaneous use as a conduit for tracheal intubation. Insertion is usually atraumatic, their use is familiar from elective anaesthesia, and compared with tracheal intubation is easier to learn for users with limited experienced in airway management. Use of SADs during difficult airway management is widely recommended in many guidelines for the operating room and in the pre‐hospital setting. Despite numerous studies comparing different SADs in manikins, there are few randomised controlled trials comparing different SADs in patients with difficult airways. Therefore, most safety data come from extended use rather than high quality evidence and claims of efficacy and particularly safety must be interpreted cautiously.

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Section: Ventilation Via Different Sads In a Difficult To Manage Airwaymentioning

confidence: 99%

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Timmermann

2011

Anaesthesia

167

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“…Bu tür hastalarda havayolu yönetimi açısından LMA kullanımı tartışmalıdır. Literatürde LMA kullanılan vakalar incelendiğinde hastaların mevcut gastroözofageal reflü problemlerinin olmadığı belirtilmesine rağmen bu vakalarda klasik LMA yerine proseal LMA kullanımı tercih edilmiştir (8,12). Bu tip olgularda Proseal LMA hem orogastrik tüp kullanılarak gastrointestinal yoldan mide içeriği aspire edilebilmeyi sağlarken hem de başarısız veya yetersiz ventilasyon olasılığını azaltır (13).…”

Section: Discussionunclassified

Anaesthetic Management of Children with Rubinstein-Taybi Syndrome

Karahan¹,

Sert²,

Ayhan³

et al. 2016

Turk J Anaesth Reanim

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Rubinstein-Taybi Sendromu (RTS); geniş başparmak, büyük ve geniş ayaklar, boy kısalığı ve kraniyofasiyal anormallikler gibi fiziksel değişiklikler ve mental retardasyon ile kendini gösteren, nadir, otozomal dominant bir sendromdur. Anestezi açısından, zor havayolu, aspirasyon pnömonisi ve kardiyovasküler işlev bozukluğu özellikle dikkat edilmesi gereken durumlardır. Mikrognati, retrognati, geniş burun köprüsü, anormal derecede büyük ya da "gaga şeklinde" burun, hipoplastik maksilla ve küçük ağız tipik dismorfik yüz özel-likleri RTS'de zor hava yolunun en önemli nedenleri arasındadır. Etkilenen bireylerin yaklaşık üçte birinde doğuştan kalp hastalıkları vardır. Sendromda mikroaspirasyon veya gastroözofageal reflüye bağlı olarak tekrarlayan solunum yolu enfeksiyonları görülür. Bu olgu sunumunda, sağ endoskopik dakriosistorinostomi planlanan RTS'li çocuk hastada anestezi yönetimini ele aldık.Anahtar kelimeler: Rubinstein-Taybi sendromu, havayolu yöne-timi, genel anestezi Rubinstein-Taybi syndrome (RTS) is a rare, autosomal dominant syndrome presenting with mental retardation and physical abnormalities, including broad thumbs, big and broad toes, short stature and craniofacial anomalies. Special attention was paid to the possibilities of difficult airway, aspiration pneumonia and cardiovascular dysfunction during anaesthesia. Micrognathia, retrognathia, broad nasal bridge, abnormally large or 'beak-shaped' nose, hypoplastic maxilla and small mouth-typical dysmorphic facial features are one of the biggest causes of the difficult airway in this syndrome. Approximately one-third of the affected individuals have a variety of congenital heart diseases. Recurrent respiratory infections are likely to be the result of microaspiration or gastro-oesophageal reflux in this syndrome. In this case report, we discussed the anaesthesia management of a child with RTS who underwent right endoscopic dacryocystorhinostomy. Giriş R ubinstein-Taybi sendromu (RTS); karakteristik yüz görünümü ile geniş el ve ayak baş parmaklarının görüldüğü ender rastlanan otozomal dominant geçişli kalıtsal bir sendromdur (1). İlk olarak 1963 yılında Jack Herbert Rubinstein ve Hosshang Taybi tarafından tanımlanan sendromun insidansı 1/250.000-300.000 olup her iki cinste eşit oranda görülmektedir. Günümüzde hastalıktan sorumlu iki gen belirlenmiştir. Hastaların %60'ından fazlasında CREBBP ve %3'ünde EP300 geni ile ilgili anormallikler saptanmıştır (2). KeywordsSendrom ile ilişkili klinik bulgular arasında; gelişme geriliği, gecikmiş kemik yaşı, zeka geriliği, solunum ve yutkunma zorlukları bulunmaktadır. Ayrıca boy kısalığı, mikrosefali, mikrognati, işitme kaybı, cilt problemleri, kalıtsal kalp anormallikleri, kriptorşitizim, renal anomaliler gibi çoklu kalıtsal kusurlar da sık görülen bulgular arasında yer almaktadır. Özellikle ilk bir yıllık dönemindeki ölümlerin başlıca nedeni aspirasyon pnömonisi ve kalıtsal kalp hastalığıdır (3).Rubinstein-Taybi sendromlu hastalarda anestezi yaklaşımı çeşitli zorluklar içermektedir. RTS'de anestezi uygulamaları açı-sı...

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“…Though the use of supraglottic airway device may be beneficial to avoid stimuli in view of respiratory infections, but it may be limited due to possibility of airway collapse, anatomical variability, and presence of hypertrophied tonsils as in our patient. [9] So, we avoided PLMA in our patient. Lower airway collapsibility may not be even managed with endotracheal tube as airway collapse distal to the secured area can manifest itself.…”

Section: Discussionmentioning

confidence: 99%

“…[4] There is a 30% incidence of cardiac dysrhythmias with or without structural changes to the heart. [9] There is increased incidence of seizures, starring spells, and spinal cord abnormalities mandating concerns during central neuraxial blocks. [12] Our patient did not have such neurological issues.…”

Section: Discussionmentioning

confidence: 99%

Perioperative management of a patient of Rubinstein-Taybi syndrome with ovarian cyst for laparotomy

Darlong

Pandey

Garg

et al. 2014

J Anaesthesiol Clin Pharmacol

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Rubinstein-Taybi syndrome (RTS) is a multisystem involvement disease. These children may present for various surgeries of different systems. Due to multisystem involvement, perioperative management of such patients poses peculiar challenges for the anesthesiologists. We report the successful anesthetic management of a patient with RTS with tonsillar hypertrophy grade III scheduled for ovarian cystectomy.

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Anaesthesia in an adult with Rubenstein-Taybi syndrome using the ProSeal laryngeal mask airway

Cited by 24 publications

References 11 publications

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Anaesthetic Management of Children with Rubinstein-Taybi Syndrome

Perioperative management of a patient of Rubinstein-Taybi syndrome with ovarian cyst for laparotomy

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