Anesthetic management of a patient with relapsing polychondritis

Fitzmaurice, Brett G.; Brodsky, Jay B.; Kee, Stephen T.; Foppiano, Linda E.; McNutt, J. T.

doi:10.1016/s1053-0770(99)90269-0

Cited by 11 publications

(5 citation statements)

References 5 publications

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“…Ventilation with a facemask was easy in our patient, but Hayward reported a case in which mask ventilation was difficult, probably due to severe obesity 5 . When difficult mask ventilation is suspected, inhalational induction without muscle relaxants or awake fibreoptic intubation should be adopted 7 . In cases of severe airway obstruction, preoperative surgical airway management, including bronchial stenting 8 , should be considered.…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic Management of a Patient with Relapsing Polychondritis Undergoing Laparoscopic Surgery

Tanaka

Furutani

Harioka

2006

Anaesth Intensive Care

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We describe the anaesthetic management of a patient with relapsing polychondritis who underwent laparoscopic cholecystectomy. We failed to secure a patent airway with a ProSeal™ laryngeal mask airway, probably because of the deformity of the larynx. The glottis was small and it was only possible to pass a 5.5 mm cuffed endotracheal tube into the trachea. Positive pressure ventilation with 5 cm H 2 O positive end-expiratory pressure and surgery were safely performed. In relapsing polychondritis, recurrent inflammation and destruction of laryngeal and tracheobronchial cartilage causes airway obstruction, and various sizes of tracheal tubes and other airway manipulation devices should be prepared.

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Section: Discussionmentioning

confidence: 99%

Anaesthetic Management of a Patient with Relapsing Polychondritis Undergoing Laparoscopic Surgery

Tanaka

Furutani

Harioka

2006

Anaesth Intensive Care

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“…A tracheostomy or surgical interventions, such as airway stenting, are indicated for patients with aggravated tracheobronchial symptoms. Airway stenting leads to considerable improvement in airflow, particularly during expiration if the collapsing segment can be broadened by a stent [6]. …”

Section: Discussionmentioning

confidence: 99%

Anesthetic experience of a patient with relapsing polychondritis -A case report-

Kim

Choi

et al. 2012

Korean J Anesthesiol

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Relapsing polychondritis is a rare disease characterized by progressive inflammation and destruction of cartilaginous structures such as ears, nose, and tracheolaryngeal structures. As a result, tracheolaryngeal involvement makes anesthetic management a challenge. Anesthetic management of a patient with relapsing polychondritis may encounter airway problems caused by severe tracheal stenosis. We present the case of a 60-year-old woman with relapsing polychondritis who underwent wedge resection of the stomach under epidural analgesia. Thoracic epidural blockade of the T4-10 dermatome was achieved by epidural injection of 7 ml of 0.75% ropivacaine and 50 µg of fentanyl. The patient was tolerable during the operation. We suggest that epidural analgesia may be an alternative to general anesthesia for patients with relapsing polychondritis undergoing upper abdominal surgery.

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“…These patients may present for bronchoscopy, tracheostomy, tracheal or nasal reconstruction, aortic valve replacement, or stent placement. 264,[267][268][269][270][271] Airway collapse after extubation should be anticipated and may be temporarily dealt with by CPAP. 272,273…”

Section: Pulmonary Aspiration Of Gastric Contentsmentioning

confidence: 99%