RESUMO
We report the anaesthetic management for a Cohen procedure in a girl with Edward's syndrome (trisomy 18). Information in the literature about anaesthetic management in trisomy 18 patients is poor. The patients are dysmorphic, have severe mental retardation and multiple organ malformations of which congenital heart disease is the most important. Our patient was a 7 year-old girl, such a survival being exceptional with trisomy 18. Anaesthesia is high risk and pain assessment is difficult. Establishing good relations with the family and appraising the need for surgical procedures are the main other difficulties.
Assuntos
Anormalidades Múltiplas/genética , Anestesia Geral , Transtornos Cromossômicos , Cromossomos Humanos 16-18 , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/genética , Trissomia , Refluxo Vesicoureteral/cirurgia , Anestésicos Inalatórios/uso terapêutico , Criança , Feminino , Humanos , Deficiência Intelectual/genética , Éteres Metílicos/uso terapêutico , Oxigênio/uso terapêutico , Sevoflurano , SíndromeRESUMO
OBJECTIVE: To analyze the current knowledge concerning xenon anaesthesia. DATA SOURCES: References were obtained from computerized bibliographic research (Medline), recent review articles, the library of the service and personal files. STUDY SELECTION: All categories of articles on this topic have been selected. DATA EXTRACTION: Articles have been analysed for history, biophysics, pharmacology, toxicity and environmental effects and using prospect. DATA SYNTHESIS: The noble gas xenon has anaesthetic properties that have been recognized 50 years ago. Xenon is receiving renewed interest because it has many characteristics of an ideal anaesthetic. In addition to its lack of effects on cardiovascular system, xenon has a low solubility enabling faster induction of and emergence from anaesthesia than with other inhalational agents. Nevertheless, at present, the cost and arety of xenon limit its widespread use in clinical practice. The developement of closed rebreathing system that allowed recycling of xenon and therefore reducing its waste has led to a recent interest in this gas. Reducing its cost will help xenon to find its place among anaesthetic agents. An European multicentric clinical trial under submission will contribute to the discussion of the opportunity for xenon introduction in anaesthesia.