PDF(Pubmed)
Abstract：
BACKGROUND: Most children with trisomy 13 display central apnea, and are prone to opioid-induced respiratory depression. We conducted opioid-free anesthesia for a patient with trisomy 13 and obstructive sleep apnea, and safely extubated the patient in the operating room.
METHODS: A 27-month-old girl with trisomy 13 underwent tonsillectomy. Given her high sensitivity to opioids, general anesthesia was introduced and maintained only with 2-5% sevoflurane and 33% nitrous oxide in oxygen. We used acetaminophen for postoperative analgesia. The tracheal tube was removed under stable breathing pattern 10 min after the surgery in the operating room. Two years later, opioid-free anesthesia with 2-5% sevoflurane and 33% nitrous oxide in oxygen was again performed safely for tube insertion into both eardrums.
CONCLUSIONS: Opioid-free anesthesia with adequate non-narcotic analgesics is safe for children with trisomy 13 with multiple apnea-related comorbidities.
METHODS: A 27-month-old girl with trisomy 13 underwent tonsillectomy. Given her high sensitivity to opioids, general anesthesia was introduced and maintained only with 2-5% sevoflurane and 33% nitrous oxide in oxygen. We used acetaminophen for postoperative analgesia. The tracheal tube was removed under stable breathing pattern 10 min after the surgery in the operating room. Two years later, opioid-free anesthesia with 2-5% sevoflurane and 33% nitrous oxide in oxygen was again performed safely for tube insertion into both eardrums.
CONCLUSIONS: Opioid-free anesthesia with adequate non-narcotic analgesics is safe for children with trisomy 13 with multiple apnea-related comorbidities.
摘要：
背景：大多数13三体患儿表现为中枢神经性呼吸暂停，并且容易发生阿片类药物引起的呼吸抑制。我们对患有13三体和阻塞性睡眠呼吸暂停的患者进行了无阿片类药物麻醉，在手术室安全拔管了病人.
方法：一名27个月大的13三体女孩接受了扁桃体切除术。鉴于她对阿片类药物的高度敏感性,仅在氧气中使用2-5％七氟醚和33％一氧化二氮进行全身麻醉并维持。我们使用对乙酰氨基酚进行术后镇痛。在手术室手术后10分钟，在稳定的呼吸模式下取出气管导管。两年后,再次安全地进行2-5％七氟醚和33％一氧化二氮在氧气中的无阿片类药物麻醉，以将管插入两个耳膜。
结论：无阿片类药物麻醉和足够的非麻醉性镇痛药对于患有13三体综合征并伴有多种呼吸暂停相关合并症的儿童是安全的。
方法：一名27个月大的13三体女孩接受了扁桃体切除术。鉴于她对阿片类药物的高度敏感性,仅在氧气中使用2-5％七氟醚和33％一氧化二氮进行全身麻醉并维持。我们使用对乙酰氨基酚进行术后镇痛。在手术室手术后10分钟，在稳定的呼吸模式下取出气管导管。两年后,再次安全地进行2-5％七氟醚和33％一氧化二氮在氧气中的无阿片类药物麻醉，以将管插入两个耳膜。
结论：无阿片类药物麻醉和足够的非麻醉性镇痛药对于患有13三体综合征并伴有多种呼吸暂停相关合并症的儿童是安全的。
