Management of difficult airway with laryngeal mask in a child with mucopolysaccharidosis and mitral regurgitation: A case report

Ziyaeifard, Mohsen; Azarfarin, Rasoul; Ferasatkish, Rasoul; Dashti, M H

doi:10.5812/cardiovascmed.17456

Cited by 11 publications

(5 citation statements)

References 19 publications

(21 reference statements)

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“…Spontaneous ventilation techniques using oxygen and a high-concentration volatile anesthetic is commonly used. Insertion of an LMA will often improve ventilation [ 7 , 32 , 41 – 45 ].…”

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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“…Spontaneous ventilation techniques using oxygen and a high-concentration volatile anesthetic is commonly used. Insertion of an LMA will often improve ventilation [ 7 , 32 , 41 – 45 ].…”

Section: Discussionmentioning

confidence: 99%

Anesthesiological risks in mucopolysaccharidoses

et al. 2018

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“…Apnea time, if extends for >1 min, can precipitate critical hypoxia [ 11 ] in an adult breathing air with normal functional residual capacity and normal oxygen consumption. Critical hypoxia and ventilatory failure can lead to death [ 12 ] or neurological insufficiency if airway is not secured timely.…”

Section: Discussionmentioning

confidence: 99%

Role of opioids as coinduction agent with propofol and their effect on apnea time, recovery time, and sedation score

Dwivedi¹,

Puri²,

Dwivedi³

et al. 2018

Int J Crit Illn Inj Sci

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Background:Laryngeal mask airway (LMA) is a supraglottic device which requires lesser depth of anaesthesia, evokes lesser hemodynamic response and causes lesser stimulation of airway as compared to traditional definitive airway device endotracheal tube. Its placement is possible without muscle relaxants thereby allowing maintenance of anaesthesia on spontaneous respiration thus preventing apnoea or minimizing apnoea time. Propofol, the commonly used induction agent, causes cardiorespiratory depression at higher induction doses. To attenuate this, co-induction agents combined with propofol has been a regular I/V anaesthetic technique these days.Aim:Comparing apnoea time, recovery time and sedation scores using propofol-fentanyl and propofol-butorphanol combination.Methodology:Hundred patients scheduled for various elective surgical procedures were randomly selected and divided into two groups of 50 each. As coinduction drug Group F received fentanyl and Group B received butorphanol. In both the groups induction was achieved with I/V propofol and LMA was placed. Apnoea time was noted after induction. Recovery time and sedation scores were recorded after anaesthetic agents were turned off.Results:As compared to group F apnoea time was significantly less and recovery time was significantly more in group B (P < 0.05). Statistically postoperative sedation was significantly higher in group B than in group F at 1/2 hr but clinically, majority were responding to verbal commands. At 1 hour no significant difference in sedation was noted between the groups.Conclusion:Considering respiratory and recovery profile propofol -butorphanol combination is a safer alternative to propofol-fentanyl combination for LMA insertion.

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“…362,363,368 Case reports observed successful ventilation and intubation with various supraglottic airways (Category B4-B evidence). 369–413…”

Section: Anticipated Difficult Airway Managementmentioning

confidence: 99%

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

Apfelbaum¹,

Hagberg²,

Connis³

et al. 2021

Anesthesiology

495

541

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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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Management of difficult airway with laryngeal mask in a child with mucopolysaccharidosis and mitral regurgitation: A case report

Cited by 11 publications

References 19 publications

Anesthesiological risks in mucopolysaccharidoses

Anesthesiological risks in mucopolysaccharidoses

Role of opioids as coinduction agent with propofol and their effect on apnea time, recovery time, and sedation score

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

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