The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Patients and Methods
2.1. Ethics Statement
2.2. Data Acquisition
2.3. Anesthesia Method
2.4. Outcome Measures
2.5. Specification of Endotracheal Tube
2.6. Statistical Analysis
3. Results
3.1. Anesthesia Methods and Intervention Procedures
3.2. General Anesthesia
3.2.1. Distribution of Subtypes of MPS Patients Underwent General Anesthesia
3.2.2. Airway Management
3.2.3. Difficulties of Airway Management
3.2.4. Respiratory and Cardiovascular Adverse Events
3.2.5. Specification of Endotracheal Tube
3.3. Neuraxial Anesthesia
3.3.1. Predominance of Adolescents and Adults
3.3.2. Cardiovascular Events: Two Cases of Hypotension
3.3.3. Necessity of Premedication and Perioperative Sedation
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Anesthesia (No./%) | Duration of Anesthesia 1 (min) | Type of Procedures | No. of Procedures Total N = 163 |
---|---|---|---|
General anesthesia (136/100%) | 148 | ||
Bag-Mask (15/11.0%) | 137.7 (60–210) | MRI 2 | 12 |
ENT 3 | 2 | ||
Orthopedic surgery | 1 | ||
Supraglottic device (15/11.7%) | 103.7 (55–325) | ENT | 7 |
General or visceral surgery | 7 | ||
Orthopedic surgery | 1 | ||
Neurosurgery | 1 | ||
Endotracheal intubation (80/58.8%) | 176.2 (60–540) | ENT | 55 |
General or visceral surgery | 19 | ||
Orthopedic surgery | 7 | ||
Dental surgery | 4 | ||
Neurosurgery | 3 | ||
Cardiac surgery | 3 | ||
Pre-existing airway (26/19.1%) | 193.5 (80–440) | ENT | 18 |
General or visceral surgery | 6 | ||
Orthopedic surgery | 1 | ||
Neurosurgery | 1 | ||
MRI | 1 | ||
Neuraxial anesthesia (15/100%) | 105.7 (45–190) | General or visceral surgery | 14 |
Orthopedic surgery | 1 |
Classification | Total Patient | Type I | Type II | Type IIIA | Type IIIB | Type IIIC | Type IVA | Type VI | Type VII |
---|---|---|---|---|---|---|---|---|---|
Episodes of anesthesia | 136 | 26 | 33 | 2 | 15 | 2 | 35 | 12 | 11 |
Gender (M/F) | 97/39 | 9/17 | 33/0 | 2/0 | 13/2 | 2/0 | 29/6 | 9/3 | 0/11 |
Age (y/o) 1 | 13.7 (0–38) | 15.2 (0–35) | 12.8 (2–25) | 9 | 5.7 (2–14) | 26 | 20.2 (6–33) | 12.6 (6–26) | 3.4 (1–6) |
Body weight (kg) | 27.4 (4.4–84) | 38.4 (4.4–84) | 29.1 (15–53) | 25 | 21.6 (15.7–36) | 42 | 26.8 (13–39.3) | 19.9 (13–33) | 11.6 (8–16.3) |
Body height (cm) 2 | 112.1 (58–167;94) | 128.1 (58–167;21) | 125.9 (98–158;17) | n.a. 4 | 108.1 (99–140;11) | 160 | 99.6 (84–129;30) | 94.6 (86–110;7) | 91.4 (86–99;6) |
Body mass index (kg/m2) | 23.4 (11.8–49.4) | 22.2 (11.8–31.6) | 21.1 (12.8–27.9) | n.a. | 18.1 (14.4–20.0) | 16.4 | 29.7 (13.2–49.4) | 20.7 (17.6–27.3) | 17.4 (16.6–19.1) |
Bag-Mask | 15 | 1 | 2 | 0 | 9 | 0 | 1 | 1 | 1 |
Supraglottic device | 15 | 2 | 6 | 0 | 1 | 0 | 2 | 2 | 2 |
Pre-existing airway | 26 | 2 | 10 | 0 | 1 | 0 | 12 | 1 | 0 |
Endotracheal intubation | 80 | 21 | 15 | 2 | 4 | 2 | 20 | 8 | 8 |
Direct laryngoscopy | 34 | 9 | 3 | 0 | 3 | 0 | 8 | 3 | 8 |
Video-assisted | 18 | 3 | 4 | 0 | 1 | 2 | 8 | 0 | 0 |
Fiberoptic or bronchoscope | 28 | 9 | 8 | 2 | 0 | 0 | 4 | 5 | 0 |
(C/L) III° or IV° documented 3 | 28 | 16 | 5 | 0 | 0 | 0 | 4 | 3 | 0 |
Difficult airway management | 12 | 4 | 3 | 0 | 0 | 0 | 2 | 3 | 0 |
Respiratory adverse event | 3 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 |
Cardiovascular adverse event | 5 | 1 | 2 | 0 | 1 | 0 | 1 | 0 | 0 |
Postoperative ICU 5 care | 54 | 10 | 17 | 1 | 5 | 0 | 13 | 4 | 4 |
Classification | Type I | Type II | Type III | Type IV | Total Patient |
---|---|---|---|---|---|
Subtype: number | I(S):1 | 11 | IIIB:1 IIIC:1 | IV(A):1 | 15 |
Fender (M/F) | 1/0 | 11/0 | 1/1 | 1/0 | 14/1 |
Age (y/o) 1 | 25 | 15.8 (7–23) | 21 (17–25) | 28 | 17.9 |
Body weight (kg) | 74 | 37.8 (24–57) | 43 (39–47) | 26.6 | 40.2 |
Body height (cm) | 161 | 133.5 (110.5–156) 2 | 152 (144–160) | h104 | 136.4 |
Dose of intrathecal 5% bupivacaine (mg) | 13 | 8.4 (5–11) | 10 | 7.5 | 8.9 |
Combine with epidural anesthesia | 0 | 1 | 0 | 0 | 1 |
Premedication for analgesia or sedation | 0 | 6 | 1 | 0 | 7 |
Intraoperative opioids | 0 | 5 | 1 | 1 | 7 |
Intraoperative midazolam or ketamine | 0 | 7 | 1 | 1 | 9 |
Intraoperative sevoflurane or propofol | 0 | 2 | 1 | 0 | 3 |
Intraoperative local anesthesia | 0 | 3 | 0 | 1 | 4 |
Duration of surgery (min) | 170 | 100.5 (55–190) | 77.5 (45–110) | 155 | 105.7 |
Hypotensive adverse event | 0 | 1 | 1 | 0 | 2 |
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Lao, H.-C.; Lin, Y.-C.; Liang, M.-L.; Yang, Y.-W.; Huang, Y.-H.; Chan, Y.-L.; Hsu, Y.-W.; Lin, S.-P.; Chuang, C.-K.; Cheng, J.-K.; et al. The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study. J. Pers. Med. 2022, 12, 1343. https://doi.org/10.3390/jpm12081343
Lao H-C, Lin Y-C, Liang M-L, Yang Y-W, Huang Y-H, Chan Y-L, Hsu Y-W, Lin S-P, Chuang C-K, Cheng J-K, et al. The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study. Journal of Personalized Medicine. 2022; 12(8):1343. https://doi.org/10.3390/jpm12081343
Chicago/Turabian StyleLao, Hsuan-Chih, Ying-Chun Lin, Muh-Lii Liang, Ying-Wei Yang, Ya-Hsien Huang, Ying-Lun Chan, Yung-Wei Hsu, Shuan-Pei Lin, Chih-Kuang Chuang, Jen-Kun Cheng, and et al. 2022. "The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study" Journal of Personalized Medicine 12, no. 8: 1343. https://doi.org/10.3390/jpm12081343
APA StyleLao, H.-C., Lin, Y.-C., Liang, M.-L., Yang, Y.-W., Huang, Y.-H., Chan, Y.-L., Hsu, Y.-W., Lin, S.-P., Chuang, C.-K., Cheng, J.-K., & Lin, H.-Y. (2022). The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study. Journal of Personalized Medicine, 12(8), 1343. https://doi.org/10.3390/jpm12081343