Anesthesia Technique for Dental Procedures in a Case with Pierre Robin Sequence

a, a and a, a and ش, ش (2013) Anesthesia Technique for Dental Procedures in a Case with Pierre Robin Sequence. Journal of Mashhad Dental School, 37 (4). pp. 357-362.

JMDS_Volume 37_Issue 4_Pages 357-362.pdf

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Introduction: Pierre Robin sequence (PRS), previously termed Pierre Robin syndrome, consists of three congenitalabnormalities: micrognathia (small mandible), glossoptosis, and cleft palate. In Pierre Robin sequence, the events occur in sequence, with one defect leadingto the next. PRS occurs with an incidence of 1 in 8500 to 25000. Affectednewborns have varying degrees of airway obstruction, often in association withgastroesophageal reflux and feeding difficulties. Intervention is mostly aimedat restoring a patent airway. Case Reports: Airway management in the infant withPierre Robin sequence can be very challenging because of difficulty with maskventilation and intubation. Our patient was a 4-year old boy with Robin sequence scheduledfor dental repair under general anesthesia. He had a history of palaterepair 3 years ago. After inhalation induction with sevofluran, nitrous-oxide inoxygen‚ under spontaneous ventilation, initial laryngeal view with theconventional Macintosh laryngoscope revealed Cormack-Lehane grade IIӀ due torestricted mouth opening and micrognathia. Nasal intubation for two timesunder the spontaneous respiration were unsuccessful. We fiberopticallyintubated the patient with uncuffed tracheal tube (ID 5 mm) while allowing himto breathe spontaneously. Extubation wasdone with the patient fully awake and with emergency airway equipmentimmediately available. Postoperatively, he was transferred to intensive careunit where he could be observed closely for delayed complications of airwayobstruction. Conclusion: Managing the airway of patients with craniofacialabnormalities can potentially be difficult. Therefore we recommend even simple treatment procedures to be carried out by experienced anesthesiologists, with a variety of different airwaydevices available such as flexible fiberoptic‚ Storz video laryngoscope and Airtraqoptical laryngoscope.

Item Type: Article
Subjects: WU Dentistry. Oral surgery
Divisions: Journals > Journal of Mashhad Dental School
Depositing User: jmds jmds
Date Deposited: 21 Sep 2017 13:52
Last Modified: 21 Sep 2017 13:52

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