Management of an anticipated difficult airway in Hurler′s syndrome

Gurumurthy, T; Shailaja, S; Kishan, Shetty; Stephen, M. James

doi:10.4103/0970-9185.142862

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…Difficulty with nasal FOB is to be expected because of the narrow nasopharyngeal path and GAG infiltration of the adenoids [ 4 , 9 , 20 ]. Intubation can also be obtained by passing the fiberscope through the LMA [ 11 , 43 , 44 ], and the new supraglottic airway device makes this procedure even easier [ 46 , 47 ]. The equipment is shown in Fig.…”

Section: Discussionmentioning

confidence: 99%

Anesthesiological risks in mucopolysaccharidoses

et al. 2018

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BackgroundPatients suffering from mucopolysaccharidosis are among the most complex from the anesthesiological point of view, especially regarding the management of the airway. The evidence base for anesthesia management is often limited to case reports and small case series.AimsTo identify useful information about experience with each subtype of mucopolysaccharidosis reported in the literature and propose a guide on the best options for airway management to the anesthesiologists who take care of these patients.MethodsA query of the PubMed database specific for “anesthesia” and “mucopolysaccharidosis” and a further query specific for “mucopolysaccharidosis and difficult airway management” was conducted. We looked for those items that offered practical guidance to anesthesiological management. We did not exclude case reports, especially those that reported a specific technique, because of their practical suggestions.ResultsWe identified 15 reviews, 17 retrospective case series, 5 prospective studies, and 28 case reports that focused on airway managements in anesthesia or had practical suggestions for preoperative evaluation and risk assessment. An accurate preoperative evaluation and the need for an experienced team are emphasized in all the reviewed articles and for each type of mucopolysaccharidosis. Many suggestions on how to plan the perioperative period have been highlighted. Insertion of a laryngeal mask airway generally improves ventilation and facilitates intubation with a fiberoptic bronchoscope. Furthermore, the videolaryngoscope is very useful in making intubation easier and facilitating bronchoscope passage.ConclusionsPatients with mucopolysaccharidosis are at high risk for anesthesia-related complications and require a high level of attention. However, a multidisciplinary approach, combined with expertise in the use of new techniques and new devices for airway management, makes anesthesiological management safer. Further research with prospective studies would be useful.Electronic supplementary materialThe online version of this article (10.1186/s13052-018-0554-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Anesthesiological risks in mucopolysaccharidoses

et al. 2018

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“…, ankylosing spondylitis, degenerative osteoarthritis, Treacher–Collins, Klippel–Feil, Down syndrome, mucopolysaccharidosis, and airway masses) (Category B4-H evidence ). 71–122…”

Section: Guidelinesmentioning

confidence: 99%

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway

Apfelbaum¹,

Hagberg²,

Connis³

et al. 2021

Anesthesiology

608

547

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The American Society of Anesthesiologists; All India Difficult Airway Association; European Airway Management Society; European Society of Anaesthesiology and Intensive Care; Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care, Learning, Teaching and Investigation Difficult Airway Group; Society for Airway Management; Society for Ambulatory Anesthesia; Society for Head and Neck Anesthesia; Society for Pediatric Anesthesia; Society of Critical Care Anesthesiologists; and the Trauma Anesthesiology Society present an updated report of the Practice Guidelines for Management of the Difficult Airway.

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“…1 Craniofacial and skeletal abnormalities in these patients include macroglossia, tonsil and adenoid hypertrophy, odontoid hypoplasia, and atlantoaxial instability. [2][3][4] Because these anomalies can complicate airway management, intubation with flexible bronchoscopy (FB) has traditionally been used in our practice in selected MPS patients. In 2009, video laryngoscopy (VL) was introduced to our practice.…”

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confidence: 99%