Sugammadex use in difficult intubation due to ankylosing spondylitis and severe restrictive respiratory disease

Öz

Bu yazıda, torasik spinal rekonstrüksiyon operasyonu planlanan, ankilozan spondilite bağlı ağır restriktif akciğer hastalığı ve zor entübasyon bulguları gösteren 50 yaşında erkek hastanın anestezi yönetimi tartışıldı. Torakal deformite nedeniyle hastanın baş ekstansiyonu kısıtlı, supin pozisyonda uyuma ve nefes almada zorluk çekiyor. Ağız açıklığında ve baş ekstansiyonundaki kısıtlılık nedeniyle hasta larengeal maske kullanılarak entübe edildi. Bronşiyal sekresyonlarda artış ve bronkospazmı önlemek, solunum kaslarının fonksiyonunu optimum düzeyde geri döndürmek için sugammadex uygulamasını takiben ekstübe edildi.

Anahtar Kelimeler

• Restriktif akciğer hastalığı, havayolu yönetimi, larengeal maske, sugammadex, ankilozan spondilit

Sugammadex use in difficult intubation due to ankylosing spondylitis and severe restrictive respiratory disease

Abstract

We describe anesthesia management of a 50-year-old man scheduled for thoracic spinal reconstruction, presenting with severe restrictive respiratory disease and difficult airway due to ankylosing spondilitis. The patient was unable to extend his head, had difficulty in breathing and sleeping in supine position due to thoracal deformities. The patient was intubated using intubating laryngeal mask airway to overcome the difficulties of limited mouth opening and head extension. He was extubated following administration of sugammadex to obtain optimal conditions in terms of respiratory muscle function and to prevent hypersecretion and bronchospasm.

Keywords

• Restrictive lung disease, airway management, laryngeal masks, sugammadex, ankylosing spondylitis

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