Abstract：
BACKGROUND: Hereditary angioedema (HAE), a genetic disorder caused by C1-inhibitor deficiency or dysfunction, may cause mucosal edema in the upper airway during tracheal intubation and extubation.
METHODS: A 57-year-old man with HAE and a history of laryngeal edema, scheduled to undergo cervical laminoplasty under general anesthesia. General anesthesia was induced by continuous injection of remimazolam and remifentanil, during which manual mask ventilation and intubation were performed without difficulty. The patient was extubated under deep anesthesia. After emergence from general anesthesia, he had no significant upper airway edema and was treated with a C1-inhibitor seven hours post-surgery because of slight tongue swelling. No additional airway edema was observed, and the patient was discharged from the intensive care unit the following day.
CONCLUSIONS: Deep anesthesia tracheal extubation with remimazolam may be effective in preventing upper airway edema during anesthetic management in patients with HAE. J. Med. Invest. 71 : 184-186, February, 2024.
METHODS: A 57-year-old man with HAE and a history of laryngeal edema, scheduled to undergo cervical laminoplasty under general anesthesia. General anesthesia was induced by continuous injection of remimazolam and remifentanil, during which manual mask ventilation and intubation were performed without difficulty. The patient was extubated under deep anesthesia. After emergence from general anesthesia, he had no significant upper airway edema and was treated with a C1-inhibitor seven hours post-surgery because of slight tongue swelling. No additional airway edema was observed, and the patient was discharged from the intensive care unit the following day.
CONCLUSIONS: Deep anesthesia tracheal extubation with remimazolam may be effective in preventing upper airway edema during anesthetic management in patients with HAE. J. Med. Invest. 71 : 184-186, February, 2024.
摘要：
背景：遗传性血管性水肿（HAE），由C1抑制剂缺乏或功能障碍引起的遗传性疾病，气管插管和拔管时可能会引起上气道粘膜水肿。
方法：一名57岁的HAE患者，有喉头水肿史，计划在全身麻醉下进行颈椎椎管成形术。全身麻醉诱导持续注射瑞马唑仑和瑞芬太尼，在此期间，没有困难地进行手动面罩通气和插管。患者在深度麻醉下拔管。全身麻醉苏醒后,患者无明显的上呼吸道水肿,术后7小时因轻微的舌头肿胀而接受C1抑制剂治疗.没有观察到额外的气道水肿，患者于次日从重症监护室出院。
结论：瑞马唑仑深度麻醉气管拔管可有效预防HAE患者麻醉管理期间的上气道水肿。J.Med.投资。71:184-186,二月,2024.
方法：一名57岁的HAE患者，有喉头水肿史，计划在全身麻醉下进行颈椎椎管成形术。全身麻醉诱导持续注射瑞马唑仑和瑞芬太尼，在此期间，没有困难地进行手动面罩通气和插管。患者在深度麻醉下拔管。全身麻醉苏醒后,患者无明显的上呼吸道水肿,术后7小时因轻微的舌头肿胀而接受C1抑制剂治疗.没有观察到额外的气道水肿，患者于次日从重症监护室出院。
结论：瑞马唑仑深度麻醉气管拔管可有效预防HAE患者麻醉管理期间的上气道水肿。J.Med.投资。71:184-186,二月,2024.
