An Experience of Anesthesia of Congenital Anomaly with Airway Involvement : 46 case report

As the improved medical techniques and environmental changes have increased the frequency of general anesthesia for uncommon congenital anomalies. The airway management for a patient with congenital anomaly gives significant challenges to the anesthesiologist. The purpose of this report is to review the authors' experience with airway management and ventilatory support during the perioperative period in children with congenital anomalies with airway involvement, and to summarize anesthetic implications associated with particular congenital anomalies by literature review. Total 46 cases of general anesthesia for operation of congenital anomalies were performed from January 2000 to August 2005 in our hospital. Most common congenital anomaly is a Down syndrome (17 cases, 37%), and most common cause of surgery is the orthopedic surgery for correction of deformed spine (18 cases, 41%). Direct laryngoscopy was successfully used to establish an airway in 35 (76.1%) cases, whereas 5 (11%) cases required the use of fiberoptic bronchoscopy to establish an airway before surgery.

An Anesthetic Experience for Russell-SilverSyndrome : A case report

We present a 4-years-old Russell-Silver syndrome patient who underwent surgical correction of left auricular abnormality. He had a triangular face with hypoplastic mandible. Because of facial manifestations of this syndrome, the anesthesiologist should prepare for a difficult endotracheal intubation and mask fitting. These patients may be prone especially to hypoglycemia and hypothermia during intraoperative period, therefore close monitoring and appropriate care for hypoglycemia and hypothermia is required. In this case, gentle direct laryngoscopy was performed to assess the airway. Hypoglycemia and hypothermia was not observed. We discuss anesthetic considerations in management.