Abstract:
Rickets is a paediatric bone disorder characterised by defective mineralisation of bony matrix due to abnormalities in calcium and phosphate metabolism. Despite being a common disease globally, literature on the anaesthetic concerns in rickets are scant. Herein, we describe the management of a 12-year-old child with symptomatic vitamin D deficiency rickets with secondary hyperparathyroidism, undergoing general anaesthesia for an urgent orthopaedic procedure. There are numerous risks involved in such a case, such as hypocalcemia, hypophosphatemia, chest and vertebral deformities, restrictive lung disease, difficult intubation and weaning, difficult regional anaesthesia, chronic bone pain, infectious complications and postoperative decreased renal function, all of which require careful preoperative assessment and risk stratification. In elective surgeries, it is important to optimise the metabolic parameters before taking up the case. However, in urgent and emergent procedures like ours, it is imperative to take up the case after informing the parents of the risks involved.
摘要:
Rickets是一种儿科骨骼疾病,其特征在于由于钙和磷酸盐代谢异常而导致的骨基质矿化缺陷。尽管是全球常见疾病,关于病的麻醉问题的文献很少。在这里,我们描述了一个有症状的维生素D缺乏症伴继发性甲状旁腺功能亢进的12岁儿童的管理,接受紧急骨科手术的全身麻醉。这种情况涉及许多风险,如低钙血症,低磷酸盐血症,胸部和椎骨畸形,限制性肺病,困难的插管和断奶,困难的区域麻醉,慢性骨痛,感染并发症和术后肾功能下降,所有这些都需要仔细的术前评估和风险分层.在选择性手术中,在处理病例之前,优化代谢参数是很重要的。然而,在像我们这样的紧急程序中,在告知父母所涉及的风险后,必须受理此案。