Anaesthetic Management of a Patient with Pseudo-TORCH Syndrome

Abstract

Background: Pseudo-TORCH syndrome is a rare, chronic disorder that is characterised by dimorphic features such as microcephaly, intracranial calcification, seizures, mental retardation, hepatosplenomegaly and coagulation disorders. Case Report: We present the anaesthetic management of a forty day-old boy with Pseudo-TORCH syndrome during magnetic resonance imaging. Microcephaly, growth failure, high palate and bilateral rales in the lungs were detected in pre-anaesthetic physical examination. The peripheral oxygen saturation was 88-89% in room-air and was 95% in a hood with 5 L/min oxygen. We planned general anaesthesia to ensure immobility during magnetic resonance imaging. After standard monitoring, general anaesthesia was induced with 8% sevoflurane in 100% O2. After an adequate depth of anaesthesia was reached, we inserted a supraglottic airway device to avoid intubation without the use of a muscle relaxant. Conclusion: In patients with Pseudo-TORCH syndrome, the perioperative anaesthetic risk was increased. We believe that using a supraglottic airway device to secure the airway is less invasive than intubation, and can be performed without the need of muscle relaxants. Turkish Anahtar Kelimeler: Psödo-TORCH Sendromu, Anestezi, Supraglottik Hava Yolu Gereci Arkaplan: Psödo-TORCH sendromu; mikrosefali, intrakraniyal kalsifikasyon, nöbetler, mental retardasyon, hepatosplenomegali ve koagülasyon bozuklukları gibi dimorfik özellikler ile karakterize nadir kronik bir hastalıktır. Manyetik rezonans görüntüleme esnasında Kırk günlük Psödo-TORCH sendromlu erkek bebekteki anestezi yönetimimizi sunmaktayız. Olgu Sunumu: Anestezi öncesi yapılan fizik muayenesinde mikrosefali, gelişme geriliği, yüksek damak ve akciğerleri dinlemekle bilateral ral tespit edildi. Oda havasında periferik oksijen saturasyonu % 88-89 ve hood eşliğinde 5 lt/dk oksijen ile % 95 idi. Manyetik rezonans görüntüleme esnasında hareketsizliği sağlamak için genel anestezi planlandı. Standart monitorizasyon sonrası, % 100 oksijen ve % 8 sevofluran ile anestezi indüksiyonu yapıldı. Yeterli anestezi derinliği sağlandıktan sonra, kas gevşetici ajan kullanılmaksızın entübasyondan kaçınmak için supraglottik hava yolu gereci kullanıldı. Sonuç: Psödo-TORCH sendromlu hastalarda perioperatif anestezi riski artmaktadır. Entübasyona göre daha az invaziv olan supraglottik hava yolu gereçlerinin kas gevşetici ihtiyacı olmaksızın hava yolu güvenliğini sağlayabileceğini düşünüyoruz.

Keywords

• Pseudo-TORCH syndrome, anaesthesia, supraglottic airway device

Anaesthetic Management of a Patient with Pseudo-TORCH Syndrome

Öz

References

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