Intravenous anaesthesia for adenoidectomy in a 3-year-old child with Kartagener syndrome and sleep disordered breathing
1,Department of Anaesthesiology and Intensive Care Medicine Split University Hospital
2ENT Department, Split University Hospital
3,Department of Internal Medicine Split University Hospital
DOI: 10.22514/SV62.102011.14 Vol.6,Issue 2,October 2011 pp.91-93
Published: 31 October 2011
Kartagener syndrome (KGS) is a rare inherited disorder characterized by situs inversus viscerum (including dextrocar-dia) and primary ciliary dyskinesia resulting in chronic respiratory tract infections, bronchiectasis and sinusitis. Possible anesthesiologic challenges are related to the respiratory system and increased susceptibility to infectious complications. There are several case reports of general anesthesia in these patients, but mainly in the adult population . Here, we report on a 3-year old female child with KGS, who underwent adenoidectomy because of sleep disordered breathing (SDB). Preoperative preparation consisted of intravenous antibiotics, steroids, as well as postural drainage and inhalations of bromhexine and salbutamol. Anesthesia was induced with propofol, fentanyl and vecuronium and maintained with a con-tinuous infusion of propofol (150-200 μg·kg-1·min-1) and supplemental doses of fentanyl. The child was ventilated with oxygen/air mixture (50%:50%) in the pressure-controlled mode of ventilation to keep end-tidal CO2 between 30 and 35 mmHg. During anesthesia the child’s hemodynamic and respiratory parameters were stable. Extubation, after thorough endotracheal and oral suction, was uneventful. After two hours in the post-anaesthesia care unit (PACU), the child was transferred to the ward. To the best of our knowledge, this is the youngest reported child with KGS and SDB that underwent intravenous general anesthesia. We also stress here the importance of comprehensive pre-anesthetic preparation, i.e. postural drainage, inhalations, bronchodilators, i.v. antibiotics and steroids. Furthermore, the condition of the respiratory system in the patient with KGS is seldom appropriate at the time of surgery, so the decision to anesthetize or not, should be made on an individual basis.
Kartagener syndrome (KGS), sleep disorder breathing (SDB), total intravenous anaesthesia (TIVA)
SANDA STOJANOVIC STIPIC,MLADEN CAREV,ZELJKA ROJE,MILEVA FRANKIC,DAMIR FABIJANIC,NENAD KARANOVIC. Intravenous anaesthesia for adenoidectomy in a 3-year-old child with Kartagener syndrome and sleep disordered breathing. Signa Vitae. 2011. 6(2);91-93.
1. Sahajananda H, Sanjay OP, Thomas J, Daniel B. General anaesthesia for lobectomy in an 8-year-old child with Kartagener's syndrome. Paediatr Anaesth 2003;13:714-7.
2. Matthew PJ, Sadera GS, Sharafuddin S, Pandit B. Anaesthetic considerations in Kartagener's syndrome – a case report. Acta Anaesthesiol Scand 2004;48:518-20.
3. Chittora SP, Raiger LK, Sood A, Dulara SC. Anaesthetic management of a child with Kartagener’s syndrome undergoing nasal polipectomy. J Anaesth Clin Pharmacol 2004;20:195-6.
4. Dylan Bould M, Gothard JW. Sudden hypoxia during anesthesia in a patient with Kartagener’s syndrome. Paediatr Anaesth 2006;16:977-80.
5. Khattab AM, El-Seify ZA, Shaaban A, Radojevic D, Jankovic I. Sevoflurane-emergence agitation: effect of supplementary low-dose oral ketamine premedication in preschool children undergoing dental surgery. Eur J Anaesthesiol 2010;27:353-8
6. Mani V, Morton NS. Overview of total intravenous anesthesia in children. Paediatr Anaesth 2010;20:211-22.
7. Lerman J, Jöhr M. Inhalational anesthesia vs total intravenous anesthesia (TIVA) for pediatric anesthesia. Paediatr Anaesth 2009;19:521-34.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus: CiteScore 0.5(2019) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.