PDF(Pubmed)
Abstract：
Children with trisomy 18 have abnormal airway anatomy, making their airway management challenging. Only a few papers have comprehensively described and discussed the use of supraglottic airway devices in patients with trisomy 18. We present a case of a 20-month-old boy with trisomy 18 who was scheduled for open repair of the right inguinal hernia. He had micrognathia, a short neck, and an atrial septal defect but was in a clinically stable condition. A supraglottic airway device was inserted under general anesthesia. The patient\'s respiration was maintained by pressure support ventilation with spontaneous breathing. A right ilioinguinal-iliohypogastric nerve block was performed for perioperative analgesia. The surgery ended without complications. After removing the supraglottic airway device and ensuring proper respiratory parameters, the patient was transferred to the post-anesthesia care unit. In our case, supraglottic airway devices could be effectively used as a primary airway for inguinal hernia repair. The concomitant ilioinguinal-iliohypogastric nerve block was helpful for anesthetic management with spontaneous breathing maintained using pressure support ventilation. A supraglottic airway device may be a potential alternative as a primary airway for superficial surgery in pediatric patients with trisomy 18. For pediatric patients with difficult airways, a second-generation supraglottic airway device with the insertion of a gastric tube to prevent gastric insufflation combining pressure support ventilation and positive end-expiratory pressure may be a beneficial choice for the maintenance of spontaneous breathing.
摘要：
18三体患儿气道解剖结构异常，使他们的气道管理具有挑战性。只有少数论文全面描述和讨论了声门上气道装置在18三体患者中的使用。我们介绍了一个20个月大的18三体男孩，他计划进行右腹股沟疝的开放式修复。他有小颌畸形,短脖子,房间隔缺损，但病情稳定。在全身麻醉下插入声门上气道装置。通过压力支持通气和自主呼吸维持患者的呼吸。行右髂腹股沟-髂腹下神经阻滞用于围手术期镇痛。手术结束时没有出现并发症。移除声门上气道装置并确保适当的呼吸参数后，患者被转移到麻醉后护理室.在我们的案例中,声门上式气道装置可有效用作腹股沟疝修补的主要气道。伴随的髂腹股沟-髂腹下神经阻滞有助于麻醉管理，并使用压力支持通气维持自主呼吸。声门上气道装置可能是18三体小儿浅表手术的主要气道的潜在替代方法。对于气道困难的儿科患者，结合压力支持通气和呼气末正压的第二代声门上气道装置可能是维持自主呼吸的有益选择。
