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The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study

Anesthesia for patients with mucopolysaccharidoses (MPS) is quite challenging due to vital systemic dysfunction following progressive accumulation of lysosomal glycosaminoglycans. Previous studies focused on perioperative difficult airway management under general anesthesia but rarely depicted the c...

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Autores principales: Lao, Hsuan-Chih, Lin, Ying-Chun, Liang, Muh-Lii, Yang, Ying-Wei, Huang, Ya-Hsien, Chan, Ying-Lun, Hsu, Yung-Wei, Lin, Shuan-Pei, Chuang, Chih-Kuang, Cheng, Jen-Kun, Lin, Hsiang-Yu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410098/
https://www.ncbi.nlm.nih.gov/pubmed/36013292
http://dx.doi.org/10.3390/jpm12081343
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author Lao, Hsuan-Chih
Lin, Ying-Chun
Liang, Muh-Lii
Yang, Ying-Wei
Huang, Ya-Hsien
Chan, Ying-Lun
Hsu, Yung-Wei
Lin, Shuan-Pei
Chuang, Chih-Kuang
Cheng, Jen-Kun
Lin, Hsiang-Yu
author_facet Lao, Hsuan-Chih
Lin, Ying-Chun
Liang, Muh-Lii
Yang, Ying-Wei
Huang, Ya-Hsien
Chan, Ying-Lun
Hsu, Yung-Wei
Lin, Shuan-Pei
Chuang, Chih-Kuang
Cheng, Jen-Kun
Lin, Hsiang-Yu
author_sort Lao, Hsuan-Chih
collection PubMed
description Anesthesia for patients with mucopolysaccharidoses (MPS) is quite challenging due to vital systemic dysfunction following progressive accumulation of lysosomal glycosaminoglycans. Previous studies focused on perioperative difficult airway management under general anesthesia but rarely depicted the concern of choosing the size of the endotracheal tube (ETT) as well as neuraxial anesthesia. This study aimed to analyze the overall anesthetic management and related complications for a thorough anesthetic strategy. Within the study period from 2002 to 2021, each record of the anesthetic and perioperative quality assurance/improvement system for patients with a diagnosis of MPS at MacKay Memorial Hospital was retrospectively reviewed. A total of 51 individuals with 151 anesthesia for 163 interventions were cohort studied, and there were 136 general anesthesia and 15 neuraxial anesthesia. We found that the most common interventions for MPS patients were otolaryngological surgeries (49.6%). Additionally, a secured airway played a marked preference for the most general anesthesia (87.1%). The incidence of difficult intubation was 12.5%. In view of ETT size, a smaller than estimated size was used in MPS type II, III, IV, and VI patients and also in patients who received intubation with multiple attempts. However, a larger than estimated size of ETT was adopted whilst choosing cuffed ones. For neuraxial anesthesia, two failed spinal anesthesia procedures were converted to general anesthesia and 73 percent of the patients received perioperative sedation. In conclusion, through the individualized anesthetic strategy and build-up of an experienced team for airway management, high-quality anesthesia can be ensured in each patient.
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spelling pubmed-94100982022-08-26 The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study Lao, Hsuan-Chih Lin, Ying-Chun Liang, Muh-Lii Yang, Ying-Wei Huang, Ya-Hsien Chan, Ying-Lun Hsu, Yung-Wei Lin, Shuan-Pei Chuang, Chih-Kuang Cheng, Jen-Kun Lin, Hsiang-Yu J Pers Med Article Anesthesia for patients with mucopolysaccharidoses (MPS) is quite challenging due to vital systemic dysfunction following progressive accumulation of lysosomal glycosaminoglycans. Previous studies focused on perioperative difficult airway management under general anesthesia but rarely depicted the concern of choosing the size of the endotracheal tube (ETT) as well as neuraxial anesthesia. This study aimed to analyze the overall anesthetic management and related complications for a thorough anesthetic strategy. Within the study period from 2002 to 2021, each record of the anesthetic and perioperative quality assurance/improvement system for patients with a diagnosis of MPS at MacKay Memorial Hospital was retrospectively reviewed. A total of 51 individuals with 151 anesthesia for 163 interventions were cohort studied, and there were 136 general anesthesia and 15 neuraxial anesthesia. We found that the most common interventions for MPS patients were otolaryngological surgeries (49.6%). Additionally, a secured airway played a marked preference for the most general anesthesia (87.1%). The incidence of difficult intubation was 12.5%. In view of ETT size, a smaller than estimated size was used in MPS type II, III, IV, and VI patients and also in patients who received intubation with multiple attempts. However, a larger than estimated size of ETT was adopted whilst choosing cuffed ones. For neuraxial anesthesia, two failed spinal anesthesia procedures were converted to general anesthesia and 73 percent of the patients received perioperative sedation. In conclusion, through the individualized anesthetic strategy and build-up of an experienced team for airway management, high-quality anesthesia can be ensured in each patient. MDPI 2022-08-21 /pmc/articles/PMC9410098/ /pubmed/36013292 http://dx.doi.org/10.3390/jpm12081343 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lao, Hsuan-Chih
Lin, Ying-Chun
Liang, Muh-Lii
Yang, Ying-Wei
Huang, Ya-Hsien
Chan, Ying-Lun
Hsu, Yung-Wei
Lin, Shuan-Pei
Chuang, Chih-Kuang
Cheng, Jen-Kun
Lin, Hsiang-Yu
The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study
title The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study
title_full The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study
title_fullStr The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study
title_full_unstemmed The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study
title_short The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study
title_sort anesthetic strategy for patients with mucopolysaccharidoses: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410098/
https://www.ncbi.nlm.nih.gov/pubmed/36013292
http://dx.doi.org/10.3390/jpm12081343
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