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Войти в исследования Case reports in medicine · 2026
Perioperative Challenges in a Patient With Sturge-Weber and Obesity Hypoventilation Syndromes.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Mincolelli Giuseppe, Izzi Antonio, Leoni Matteo Luigi Giuseppe, Marchello Vincenzo, Carlo Maria Grazia Di, Cascella Marco, Recchia Andreaserena, Corso Ruggero Massimo
Аннотация
BACKGROUND: The rare concurrence of Sturge-Weber syndrome (SWS) and obesity hypoventilation syndrome (OHS) presents significant anesthetic challenges, with complexity in airway management and perioperative respiratory care.
CASE PRESENTATION: A 55-year-old man with SWS and OHS underwent elective dental extraction. He was advised to undergo continuous positive airway pressure (CPAP) therapy (10 cmH2O) preoperatively. Premedication included intramuscular clonidine (2 μg/kg). Awake fiberoptic intubation was performed under high-flow nasal oxygen (HFNO) support. Anesthesia was maintained with propofol and remifentanil via target-controlled infusion. In the PACU, CPAP intolerance led to desaturation (SpO2 80%), which was rapidly corrected with HFNO (50-70 L/min, FiO2 60%-80%), restoring SpO2 > 94% within 3 min. The patient was discharged after 24 h of uneventful monitoring.
CONCLUSIONS: Awake fiberoptic intubation and the use of HFNO under strict ventilatory monitoring, as a rescue or bridging strategy, can facilitate safe anesthetic management in high-risk patients with SWS and OHS who are CPAP-intolerant. This case highlights the importance of multidisciplinary planning and individualized respiratory support strategies.
CASE PRESENTATION: A 55-year-old man with SWS and OHS underwent elective dental extraction. He was advised to undergo continuous positive airway pressure (CPAP) therapy (10 cmH2O) preoperatively. Premedication included intramuscular clonidine (2 μg/kg). Awake fiberoptic intubation was performed under high-flow nasal oxygen (HFNO) support. Anesthesia was maintained with propofol and remifentanil via target-controlled infusion. In the PACU, CPAP intolerance led to desaturation (SpO2 80%), which was rapidly corrected with HFNO (50-70 L/min, FiO2 60%-80%), restoring SpO2 > 94% within 3 min. The patient was discharged after 24 h of uneventful monitoring.
CONCLUSIONS: Awake fiberoptic intubation and the use of HFNO under strict ventilatory monitoring, as a rescue or bridging strategy, can facilitate safe anesthetic management in high-risk patients with SWS and OHS who are CPAP-intolerant. This case highlights the importance of multidisciplinary planning and individualized respiratory support strategies.