[Anesthetic management of a patient with 8 trisomy mosaic combined with cerebral palsy].
We administered general anesthesia for a patient with 8 trisomy mosaic and cerebral palsy. Constitutional 8 trisomy mosaic has been associated with syndromic dysmorphology, corneal opacities, leukemia and trophoblastic disease. In Japan only 4 reports of general anesthesia related with 8 trisomy were found. This patient was a 24-year-old woman (140 cm, 35 kg), with mental retardation, poor body development and severe scoliosis. Since she suffered from repeated serious asthma and pneumonia since childhood, tracheotomy was performed at the age of 9. Epileptic seizures were also seen and antiepileptics were prescribed. This time, general anesthesia was scheduled for the extraction of a maxillary cyst. Anesthesia was induced slowly with sevoflurane from the tracheotomy, followed by rocuronium 25 mg i.v., and maintained with sevoflurane 1.5-2 % and remifentanil 0.05-0.2 microg x kg(-1) x min(-1) Throughout the operation, BIS score fluctuated between 40-60, and stable anesthesia was maintained. We reversed the rocuronium with sugammadex 140 mg promptly. The 8 trisomy mosaic patient is known to have various complications related to circulation and respiration. Careful management is necessary in anesthesia for an 8 trisomy patient.
Kazuko
K
Matsuda
Tsutomu
T
Yakushiji
Jyunkei
J
Ryo
Soken
S
Higashimoto
Kotatsu
K
Sasaki
D000768:Anesthesia, General / Q000379:methods*; D002547:Cerebral Palsy / Q000150:complications*; D002898:Chromosomes, Human, Pair 8; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D007570:Jaw Cysts / Q000601:surgery; D008439:Maxillary Diseases / Q000601:surgery; D009030:Mosaicism; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D014314:Trisomy; D024182:Uniparental Disomy; D055815:Young Adult