Aggravated sleep apnea after general anesthesia in a patient with Shy-Drager syndrome

Oshima, Shigenori; Sugihara, Kazuho; Wakayama, S

doi:10.1007/bf02514633

Cited by 1 publication

(2 citation statements)

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“…As with any structural or functional disorder involving the vocal cords or glottic apparatus, this can result in difficult endotracheal intubation. Oshima reported a transient deterioration in laryngeal function following anesthesia in a patient with MSA, resulting in complete glottic obstruction and sudden death 40 . The combination of impaired gastrointestinal motility and laryngeal dysfunction make aspiration a particular concern in these patients.…”

Section: Special Considerations In Intraoperative Clinical Managementmentioning

confidence: 99%

“…In addition to hypoxemia, apnea in these patients can have significant effects on blood pressure due to the resulting hypercapnea. The effect of hypercapnea on blood pressure should also be taken into consideration when titrating opioids or other respiratory depressants in the operating room and post-operatively 40;42;43 .…”

Section: Special Considerations In Intraoperative Clinical Managementmentioning

confidence: 99%

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Dysautonomia

et al. 2012

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Severe autonomic failure occurs in about 1 in 1000 people. Such patients are remarkable for the striking and sometimes paradoxical responses they manifest to a variety of physiologic and pharmacologic stimuli. Orthostatic hypotension is often the finding most commonly noted by physicians, but a myriad of additional and less well-understood findings also occur. These include supine hypertension, altered drug sensitivity, hyperresponsiveness of blood pressure to hypo/hyperventilation, sleep apnea and other neurological disturbances are also frequently encountered. In this article we will review the clinical pathophysiology that underlies autonomic failure, with a particular emphasis on those aspects most relevant to the care of such patients in the perioperative settings. Strategies used by clinicians to diagnose and treat these patients, and the impact of these interventions on the pre-operative, intra-operative, and post-operative care that these patients undergo is a crucial element in the optimized management of care in these patients.

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Section: Special Considerations In Intraoperative Clinical Managementmentioning

confidence: 99%