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Anesthetic management of a Rett syndrome patient with apnea and epilepsy: a case report

Rett syndrome, which is a progressive, central nervous system disease that is caused by a gene mutation, is known to present with various symptoms. This case is that of a 15-year-old girl who was diagnosed with Rett syndrome at the age of 2 years. Laryngotracheal isolation under general anesthesia w...

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Autores principales: Motomura, Yuka, Idei, Masafumi, Sato, Hitoshi, Goto, Takahisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6967320/
https://www.ncbi.nlm.nih.gov/pubmed/32026952
http://dx.doi.org/10.1186/s40981-018-0169-y
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author Motomura, Yuka
Idei, Masafumi
Sato, Hitoshi
Goto, Takahisa
author_facet Motomura, Yuka
Idei, Masafumi
Sato, Hitoshi
Goto, Takahisa
author_sort Motomura, Yuka
collection PubMed
description Rett syndrome, which is a progressive, central nervous system disease that is caused by a gene mutation, is known to present with various symptoms. This case is that of a 15-year-old girl who was diagnosed with Rett syndrome at the age of 2 years. Laryngotracheal isolation under general anesthesia was planned due to recurrent aspiration pneumonia. Since the patient’s nutritional status and control of convulsions were good, this was deemed an appropriate time for the surgery. Following careful preoperative evaluation of her airway, we performed oral endotracheal intubation using a video laryngoscope after rapid induction. Since postoperative pain control was important to prevent apneic attacks and convulsions, we used a multimodal analgesic regimen including carefully titrated fentanyl, acetaminophen, nonsteroidal anti-inflammatory drug, and wound infiltration with a local anesthetic. Postoperatively, the patient returned to the intensive care unit under spontaneous ventilation and followed a good course. Patients with Rett syndrome present several symptoms. Thus, several points must be considered during the preoperative evaluation, anesthetic management, and postoperative care of these patients.
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spelling pubmed-69673202020-02-04 Anesthetic management of a Rett syndrome patient with apnea and epilepsy: a case report Motomura, Yuka Idei, Masafumi Sato, Hitoshi Goto, Takahisa JA Clin Rep Case Report Rett syndrome, which is a progressive, central nervous system disease that is caused by a gene mutation, is known to present with various symptoms. This case is that of a 15-year-old girl who was diagnosed with Rett syndrome at the age of 2 years. Laryngotracheal isolation under general anesthesia was planned due to recurrent aspiration pneumonia. Since the patient’s nutritional status and control of convulsions were good, this was deemed an appropriate time for the surgery. Following careful preoperative evaluation of her airway, we performed oral endotracheal intubation using a video laryngoscope after rapid induction. Since postoperative pain control was important to prevent apneic attacks and convulsions, we used a multimodal analgesic regimen including carefully titrated fentanyl, acetaminophen, nonsteroidal anti-inflammatory drug, and wound infiltration with a local anesthetic. Postoperatively, the patient returned to the intensive care unit under spontaneous ventilation and followed a good course. Patients with Rett syndrome present several symptoms. Thus, several points must be considered during the preoperative evaluation, anesthetic management, and postoperative care of these patients. Springer Berlin Heidelberg 2018-04-18 /pmc/articles/PMC6967320/ /pubmed/32026952 http://dx.doi.org/10.1186/s40981-018-0169-y Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Motomura, Yuka
Idei, Masafumi
Sato, Hitoshi
Goto, Takahisa
Anesthetic management of a Rett syndrome patient with apnea and epilepsy: a case report
title Anesthetic management of a Rett syndrome patient with apnea and epilepsy: a case report
title_full Anesthetic management of a Rett syndrome patient with apnea and epilepsy: a case report
title_fullStr Anesthetic management of a Rett syndrome patient with apnea and epilepsy: a case report
title_full_unstemmed Anesthetic management of a Rett syndrome patient with apnea and epilepsy: a case report
title_short Anesthetic management of a Rett syndrome patient with apnea and epilepsy: a case report
title_sort anesthetic management of a rett syndrome patient with apnea and epilepsy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6967320/
https://www.ncbi.nlm.nih.gov/pubmed/32026952
http://dx.doi.org/10.1186/s40981-018-0169-y
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