Author/Editor     Šervicl-Kuchler, Darja
Title     Moebiusov sindrom in anestezija - klinični primer
Translated title     Moebius syndrome and anaesthesia - case report
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 74, št. 2
Publication year     2005
Volume     str. 75-7
Language     slo
Abstract     Background. Moebius syndrome is a congenital disorder involving the 6th and 7th cerebral nerves. It very often involves facial and limb anomalies, and the children with this disorder can be mentally retarded. Reasons for Moebius syndrome are various and not fully understood. Children with this disease undergo a lot of corrective surgery that requires anaesthesia. Due to their facial anomalies, we have to expect intubation difficulties with these patients. Material and methods. This clinical case report presents a 21-month-old girl with Moebius syndrome who underwent surgery for clubfoot correction under general anaesthesia. We expected difficult airways, and the child also had a history of complications during anaesthesia. During the induction of anaesthesia we encountered a complication associated with the regurgitation of tea. This occurred even though she had not eaten or drunk that day. After a successful intubation with a fibre-optic bronchoscope the surgery was successfully completed. Conclusions. When dealing with a Moebius-syndrome patient, we have to expect a difficult intubation because of the numerous problems associated with this syndrome. We successfully intubated our patient with a fibre-optic bronchoscope. What we did not expect was the regurgitation of tea from the stomach. In related literature we did not find any data about delayed gastric emptying.
Summary     Izhodišča. Moebiusov sindrom je prirojena bolezen s parezo 6. in 7. možganskega živca, ki so ji pridružene še nepravilnosti obraza in udov. Otroci so lahko umsko zaostali, celo avtisti. Vzroki so različni in še niso popolnoma raziskani. Bolnike pogosto operirajo zaradi osnovne bolezni. Pri anesteziji je zaradi obraznih nepravilnosti lahko otežena intubacija. Bolniki in metode. 21-mesečna deklica z Moebiusovim sindromom je bila zaradi operativne korekcije konjskega spodvitega stopala predvidena za poseg v splošni anesteziji. Težko intubacijo smo zaradi obraznih nepravilnosti pričakovali. V anamnezi so prisotni tudi zapleti med poprejšnjo anestezijo zaradi zatekanja in vdihnenja želodčne vsebine. Tudi pri nas je pri poskusu intubacije prišlo do zatekanja čaja iz želodca, čeprav naj bi bila deklica tešča. Po intubaciji s fiberoptičnim bronhoskopom je bila operacija uspešno izvedena. Zaključki. Pri bolnikih z Moebiusovim sindromom moramo zaradi prisotnih obraznih nepravilnosti pričakovati težko intubacijo. Pri naši bolnici smo težko intubacijo predvideli in jo tudi uspešno izvedli z fiberoptičnim bronhoskopom. Nismo pa predvideli možnosti obilnega zatekanja želodčne vsebine. Upočasnjeno praznjenje želodca pri tem sindromu v razpoložljivi literaturi ni opisano.
Descriptors     FACIAL PARALYSIS
FACIAL BONES
CLUBFOOT
ANESTHESIA, GENERAL
INTUBATION, INTRATRACHEAL
INFANT
BRONCHOSCOPY
GASTROESOPHAGEAL REFLUX