ABSTRACT
A 9-year-old boy diagnosed with gingival hypertrophy and with a history of West syndrome and associated low platelet levels underwent gingival reduction surgery. Because difficult intubation was foreseen, the fiberoptic tube was inserted through the nose with the patient breathing spontaneously under remifentanil for sedation and analgesia. The procedure was carried out under balanced general anesthesia and with standard monitoring. At the end of gingivectomy, a tracheostomy was performed and the patient was transferred to the pediatric intensive care unit for postoperative observation.
Subject(s)
Airway Obstruction/etiology , Analgesics, Opioid/therapeutic use , Bronchoscopy , Gingival Hypertrophy/complications , Hypnotics and Sedatives/therapeutic use , Intubation, Intratracheal , Nose , Piperidines/therapeutic use , Spasms, Infantile/complications , Anticonvulsants/adverse effects , Child , Fiber Optic Technology , Gingival Hypertrophy/chemically induced , Gingival Hypertrophy/surgery , Humans , Infant , Intellectual Disability/complications , Intubation, Intratracheal/instrumentation , Male , Phenytoin/adverse effects , Remifentanil , Spasms, Infantile/drug therapy , Tooth Extraction , TracheostomyABSTRACT
Se presenta el caso de un niño de 9 años diagnosticado de hipertrofia gingival gigante con antecedentes personales de Síndrome de West con plaquetopenia asociada, que fue sometido a una intervención quirúrgica de gingivectomía. Tratándose de una situación de intubación difícil prevista se decide realizar mediante fibrobroncoscopio por vía nasal en respiración espontánea bajo sedoanalgesia con remifentanilo. La intervención se realizó bajo anestesia general balanceada y monitorización estándar. Al finalizar la gingivectomía se procedió a la realización de traqueostomía y posterior traslado a Unidad de Cuidados Intensivos de Pediatría para control postoperatorio
A 9-year-old boy diagnosed with gingival hypertrophy and with a history of West syndrome and associated low platelet levels underwent gingival reduction surgery. Because difficult intubation was foreseen, the fiberoptic tube was inserted through the nose with the patient breathing spontaneously under remifentanil for sedation and analgesia. The procedure was carried out under balanced general anesthesia and with standard monitoring. At the end of gingivectomy, a tracheostomy was performed and the patient was transferred to the pediatric intensive care unit for postoperative observation
