Successful spinal anesthesia in a patient with mucopolysaccharidosis type I under femoral fracture reduction and external fixation

Sun, Lihua; Jian-min, Zhang; Zhao, Xin

doi:10.1002/ped4.12116

Cited by 1 publication

(1 citation statement)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to general anesthesia with great concerns of airway management, neuraxial anesthesia for MPS patients may be preferable for surgeries of the lower body. However, there were only few case reports [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ] of successful regional anesthesia performed contrast to few cases of failed attempts [ 14 , 15 ] and one case of catastrophic sequala [ 16 ]. This study aimed to exploit and analyze anesthetic management and related complications from our experience in the past 20 years for a thorough anesthetic strategy for patients with MPS.…”

Section: Introductionmentioning

confidence: 99%

The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study

Lao

Lin

Liang

et al. 2022

JPM

View full text Add to dashboard Cite

Anesthesia for patients with mucopolysaccharidoses (MPS) is quite challenging due to vital systemic dysfunction following progressive accumulation of lysosomal glycosaminoglycans. Previous studies focused on perioperative difficult airway management under general anesthesia but rarely depicted the concern of choosing the size of the endotracheal tube (ETT) as well as neuraxial anesthesia. This study aimed to analyze the overall anesthetic management and related complications for a thorough anesthetic strategy. Within the study period from 2002 to 2021, each record of the anesthetic and perioperative quality assurance/improvement system for patients with a diagnosis of MPS at MacKay Memorial Hospital was retrospectively reviewed. A total of 51 individuals with 151 anesthesia for 163 interventions were cohort studied, and there were 136 general anesthesia and 15 neuraxial anesthesia. We found that the most common interventions for MPS patients were otolaryngological surgeries (49.6%). Additionally, a secured airway played a marked preference for the most general anesthesia (87.1%). The incidence of difficult intubation was 12.5%. In view of ETT size, a smaller than estimated size was used in MPS type Ⅱ, Ⅲ, Ⅳ, and Ⅵ patients and \also in patients who received intubation with multiple attempts. However, a larger than estimated size of ETT was adopted whilst choosing cuffed ones. For neuraxial anesthesia, two failed spinal anesthesia procedures were converted to general anesthesia and 73 percent of the patients received perioperative sedation. In conclusion, through the individualized anesthetic strategy and build-up of an experienced team for airway management, high-quality anesthesia can be ensured in each patient.

show abstract