Positional Change Used to Manage Postextubation Respiratory Failure in a Child With Cerebral Palsy

Jun Hirokawa, Kouichi Hidaka, Mitsuyo Kanemaru, Takashi Hitosugi, Yu Oshima, Takeshi Yokoyama

研究成果: ジャーナルへの寄稿学術誌査読

抄録

Dental treatment for patients with cerebral palsy (CP) is often performed under general anesthesia due to involuntary movements that can render dental treatment difficult. Since CP is often accompanied by spasticity, care must be taken when positioning patients during general anesthesia. We report the management of a 14-year-old girl with CP and epilepsy undergoing general anesthesia for dental treatment who experienced respiratory failure due to acute thoracoabdominal muscle hypertonia after extubation. She had a history of cardiac arrest due to respiratory failure caused by acute muscle hypertonia and successful resuscitation. General anesthesia was induced after careful positioning of the patient to prevent spastic muscle stretching, and the dental treatment was completed without complications. However, upon awakening after extubation, the patient developed respiratory failure due to acute muscle hypertonia. The patient was resedated and repositioned from a supine to a sitting position, and her symptoms improved. There was no recurrence of muscle hypertonia, and she recovered fully without complications. In this case, respiratory failure associated with acute muscle hypertonia was successfully managed by position change after initial treatment with positive-pressure ventilation and propofol. It is important to be prepared for the possibility of respiratory failure associated with acute muscle hypertonia and its countermeasures when providing general anesthesia for patients with CP.

本文言語英語
ページ(範囲)124-127
ページ数4
ジャーナルAnesthesia progress
70
3
DOI
出版ステータス出版済み - 2023

!!!All Science Journal Classification (ASJC) codes

  • 医学一般

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