Akondroplazik bir hastada anestezi uygulaması (Olgu sunumu)

Akondroplazi, cüceliğin en yaygın nedenidir. Anestezisi açısından önemli olan akondroplazik olguda bir çok problemle (üst hava yolu güçlüğü, kardiyopulmoner anomaliler, nörolojik ve ısı regülasyon anomalileri vb.) karşı karşıya gelinmesidir. Bu yazımızda; genel anestezi altında miyomektomi yapılan bir akondroplazi olgusu ve bu olgularda olası anestezi problemleri literatür eşliğinde tartışıldı.

Anahtar Kelimeler:

Anestezi, genel, Akondroplazi, Cerrahi işlemler, operatif, Tedavi sonucu, Erişkin, Ameliyat sonrası dönem, Cücelik

Anesthetic management of achondroplasic case (Case report)

Achondroplasia is the most common cause of dwaffism. According to anesthesiologists, achondroplasic patient carries a lot of potential problems such as; difficult upper airway, cardiopulmonary, neurological and the rinoregulatory abnormalities etc. In this report, anesthetic management and problems related to anesthesia of an achondroplasic case undergoing myomectomy were discussed.

Keywords:

Anesthesia, General, Achondroplasia, Surgical Procedures, Operative, Treatment Outcome, Adult, Postoperative Period, Dwarfism,

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1. Tyson JE, Barnes AC, McKusick VA, Scott CI, Jones GS. Obstetric and gynecologic considerations of dwarfism. Am J Obst Gynecol 1970;108:688-703.
2. Berkowitz TD, Raja SN, Bender KS, Kopits SE.Dvarfs. Pat-hophysiology and anesthetic implications. Anesthesiology 1990; 73:739-59.
3. Stoelting RK. Anesthesia and Co-existing Disease: Skin and Musculoskeletal Diseases. New York, Churchill Livingstone, 1993; 427-457.
4. Katz J, Mayhew JF. Air embolism in the achondroplastic dwarf. Anesthesiologyl985;63:205-7.
5. Kalla GN, Fening E, Obiaya MO. Anaesthetic management of achondroplasia. Br J Anaesth 1986;58:117-9.
6. Wardall GJ, Frame WT. Extradural anaesthesia for caesarean section in achondroplasia. Br J Anaesth 1990;64:367-70.
7. Morrow MJ, Black IH. Epidural anaesthesia for caesarean section in an achondroplastic dvarf. Br J Anaesth 1998:81:619-21.
8.Cartoniu J,Yee I,Halpern S.Epidural anaesthesia for caesarean section in an achondroplastic dwarf. Can J Anaesth 1992; 39:708-11. 9. Brimacombe JR, Caunt JA. Anaesthesia in a gravid achondroplastic dwarf. Anaesthesia 1990; 45:132-4.
10. Crawford M, Dutton DA. Spinal anaesthesia for caeserean section in an achondroplastic dwarf. Anaesthesia 1992; 47: 1007.
11. Lugo N, Becker J, Bosse HV, Campbell W, Evans B, Sagy M. Lung volume histograms after computed tomography of the chest with three-dimensional imaging as a method to substantiate succesfull surgical expansion of the rib cage in achondroplasia. J Pediatr Surg 1998; 33: 733-6.
12. Monedero P, Qarcia PF, Coca I, Fernandez- LJI, Panadero A, de los Rios J. Is management of anesthesia in achondroplastic dwarfs really a challenge? J Clin Anesth 1997; 9: 208-12.
13. Sisk EA, Heatley DG, Borowski BJ, Leverson GE, Pauli RM. Obstructive sleep apnea in children with achondroplasia: surgical and anesthetic considerations. Otolaryngol Head Neck Surg 1999; 120:248-54. 14. Nelson FW, Hecht JT, Horton WA, Butler IJ, Goldie WD, Miner M. Neurological basis of respiratory complications in achondroplasia. Ann Neur, 1988; 24: 89-93.
15. Lonstein JE. Anatomy of the lumbar spinal canal. Basic Life Sci 1988; 48: 219-26.