Anesthetic management for surgery of esophagus atresia in a newborn with Goldenhar's syndrome

Revista Brasileira de Anestesiologia

Rosana Guerrero-domínguez¹  Daniel López-herrera-rodríguez¹  Inmaculada Benítez-linero¹  Antonio Ontanilla¹ 

关键词: Goldenhar's syndrome;    Tracheoesophageal fistula;    Esophageal atresia;    Difficult airway;    Fibrobronchoscope;    Síndrome de Goldenhar;    Fístula traqueoesofágica;    Atresia de esôfago;    Via respiratória difícil;    Fibrobroncoscópio;    Síndrome de Goldenhar;    Fístula traqueoesofágica;    Atresia de esófago;    Vía aérea difícil;    Fibrobroncoscopio;   

DOI  :  10.1016/j.bjane.2013.07.011

来源: SciELO

【 摘 要 】

Goldenhar's syndrome is a polymalformative condition consisting of a craniofacial dysostosis that determines difficult airway in up to 40% of cases. We described a case of a newborn with Goldenhar's syndrome with esophageal atresia and tracheoesophageal fistula who underwent repair surgery. We report the case of a 24-h-old newborn with Goldenhar's syndrome. He had esophageal atresia with distal tracheoesophageal fistula. It was decided that an emergency surgery would be performed for repairing it. It was carried out under sedation, intubation with fibrobronchoscope distal to the fistula, to limit the air flow into the esophagus, and possible abdominal distension. Following complete repair of the esophageal atresia and fistula ligation, the patient was transferred to the intensive care unit and intubated under sedation and analgesia. The finding of a patient with Goldenhar's syndrome and esophageal atresia assumes an exceptional situation and a challenge for anesthesiologists, since the anesthetic management depends on the patient comorbidity, the type of tracheoesophageal fistula, the usual hospital practice and the skills of the anesthesiologist in charge, with the main peculiarity being maintenance of adequate pulmonary ventilation in the presence of a communication between the airway and the esophagus. Intubation with fibrobronchoscope distal to the fistula deals with the management of a probably difficult airway and limits the passage of air to the esophagus through the fistula.

【 授权许可】

CC BY-NC-ND   
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