[Anesthetic management of a patient with Stickler's syndrome].
Stickler's syndrome is an autosomal multisystem disorder accompanying characteristic midface hypoplasia, retromicrognathia, and cleft palate. Mandibular hypoplasia causes difficulties in mask ventilation and endotracheal intubation, especially in infants. A 7-month-old girl diagnosed as Stickler's syndrome was scheduled for the laparoscopic inguinal hernia repair. However, during the direct laryngoscopy for endotracheal intubation, neither the vocal cords nor the epiglottis were visualized. At fifth intubation attempts, the part of the vocal cords was barely visualized, and the tracheal intubation was finaly successful. Anesthesia was maintained with sevoflurane and remifentanil. The patient had an uneventful recovery and was discharged on the second postoperative day without any complications. Sevoflurane and remifentanil allow faster recovery from anesthesia and both have been recommended for patients with difficult tracheal intubation in a patient such as with Stickler's syndrome.
Okuno
Eita
E
Department of Anesthesiology, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0215.
Miyata
Yuji
Y
Uemura
Takeaki
T
Saikawa
Satoko
S
Noguchi
Nobuhiro
N
Fuchibe
Makoto
M
Sugahara
Kazuhiro
K
D000758:Anesthesia; D002972:Cleft Palate; D005145:Face / Q000002:abnormalities*; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000379:methods*; D010535:Laparoscopy; D007828:Laryngoscopy; D008738:Methyl Ethers; D009056:Mouth Abnormalities; D010880:Piperidines; D000077208:Remifentanil; D000077149:Sevoflurane; D013577:Syndrome
D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil