重度側彎による気管圧排を呈するShprintzen-Goldberg症候群患児の麻酔経験

Anesthetic Management of a Child with Shprintzen-Goldberg Syndrome Presenting with Tracheal Compression due to Severe Scoliosis

要旨

　Shprintzen-Goldberg症候群患児の側彎症矯正術の際に，気管切開孔から気管チューブを挿管した管理では体位変換後に換気が困難であった。その原因が胸椎による主気管支の圧排と考え，経口挿管した左用二腔チューブの気管支チューブを主気管支の狭窄部に留置した結果，体位変換後も換気が可能であった。

　A 13-year-old male with Shprintzen-Goldberg syndrome underwent scoliosis surgery due to deteriorating pulmonary function. The ventilation for the surgery became difficult when the patient was anesthetized with a single-lumen tracheal tube through a tracheotomy while in the prone position. We speculated that the difficulty in ventilation might be due to the compression of the right main bronchus by the thoracic vestibular body during the postural change, and the patient was thus orally intubated using a left double-lumen tube, with the bronchial tube placed in the most constricted part. As a result, we were able to resume the ventilation during the surgical procedure.