Anesthetic experience using total intra-venous anesthesia for a patient with Wolf-Hirschhorn syndrome: A case report / 대한마취과학회지

We present here the case of a 33-month-old male patient with Wolf-Hirschhorn syndrome (WHS) and who underwent tympanoplasty and myringotomy. WHS is caused by a rare chromosomal abnormality, which is the deletion of the short arm of chromosome number 4. The typical craniofacial features of WHS patients such as micrognathia, microcephaly and the muscular weakness can make using neuromuscular blocking agents and performing intubation difficult. Moreover, there are a few previous case reports showing that malignant hyperthermia occurred during and after an operation in which the anesthesia was done with inhalation agents, so special anesthetic care is needed when operating on a WHS patient. By carefully intubating the patient and using total intravenous anesthesia, we performed successful anesthesia without any complications. We describe here the anesthetic management of a WHS patient and we review the relevant literature.

Propofol combined with midazolam intravenous sedation anesthesia in pediatric upper gastrointestinal endoscopy / 中南大学学报(医学版)

Objective To explore the application of propofol combined with midazolam intrave-nous anesthesia in pediatric upper gastrointestinal endoscopy, Methods A total of 497 ASA Ⅰ～Ⅱ patients who received sedative upper gastrointestinal endoscopy were assigned to a children group (2～14 years) and an adults group (18～65 years). The 2 groups were treated with midazolam (0.02～0.03 mg/kg, iv) and propofol (0.6～0.7 mg/s, iv) with an interval of 3～5 minutes. Enterseopy was inserted at light sleep, relaxing muscles, and disappearance of eyelash relaxation. Combining of pro-endoscopy, reaction to intravenous administration, dose of propofol, reaction to en-doscopy, time of returning to consciousness, changes of SpO2, R, HR, and BP, and sedative quali-ty were evaluated. Results Good sedation of the 2 groups after intravenous administration was ob-served. Rate of combining of pro-endoscopy in children was lower (42%) than that in adults (100%). The incidence of restlessness, hyperphasia, temporary decreasing of SpO2, dose of propofol of per kilogram weight, time of returning to consciousness in the children were 82.7%, 17%, 2.4 mg/kg, and (17.5±3.2)min, respectively, which were all higher in the adults [9%,4%,1.4 mg/kg, and (9.5±1.3)min, P<0.01]. HR and BP decreased in the 2 groups, and recovered rapidly after the endoscopy. There was no significant difference between the 2 groups (P>0.05). Conclusion It is safe and effective to use propofol combined with midazolam intravenous sedation anesthesia in pediatric upper gastrointestinal endoscopy.