Abstract
The anaesthetic management of a child with Goldenhar’ s syndrome and upper airway dysmorphology is presented. She had a history of severe dyspnoea due to deterioration of cor pulmonale caused by upper airway obstruction. The patency of the upper airway and oxygenation were evaluated during the perioperative period with respiratory inductive plethysmography (RIP) and pulse oximetry, which did not show severe upper airway obstruction or oxygen saturation below 80 per cent. Tracheal intubation was performed under inhalational anaesthesia with spontaneous breathing. This case suggests that RIP and pulse oximetry may be useful monitoring devices in the anaesthetic management of patients with upper airway problems as in Goldenhar’s syndrome.
Résumé
Nous décrivons l’anesthésie d’une enfant etteinte d’un syndrome de Goldenhar avec dysmorphie des voies respiratoires supérieures, dont l’obstruction avait amenée une dyspnée importante avec défaillance ventriculaire droite. En utilisant un pléthysmographe à inductance respiratoire et un oxymètre de pouls, nous avons pu determiner avant l’intervention, que l’obstruction n’était pas sévère et que la saturation artérielle en oxygène se maintenait au dessus de 80 pour cent. Nous avons pu intuber la trachée de l’enfant après une induction par anesthésiques inhalés en ventilation spontanée. Cette technique et les moniteurs utilisés peuvent ainsi être utiles dans des cas d’obstruction haute des voies respiratoires.
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Aoe, T., Kohchi, T. & Mizuguchi, T. Respiratory inductance plethysmography and pulse oximetry in the assessment of upper airway patency in a child with Goldenhar’s syndrome. Can J Anaesth 37, 369–371 (1990). https://doi.org/10.1007/BF03005593
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DOI: https://doi.org/10.1007/BF03005593