Pierre Robin Sequence Posted for Palatoplasty: An Anaesthetic and Analgesia Management
Pierre Robin Sequence (PRS) is characterised by micrognathia, glossoptosis, Cleft Palate (CP) and cardiac defects. The key anaesthetic concerns in managing PRS include the patient’s age, assessment of associated congenital birth defects or syndromes and the potential for a shared airway and anticipa...
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JCDR Research and Publications Private Limited
2025-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/20764/75065_CE[Ra1]_F(SL)_PF1(KrA_OM)_redo_PFA(IS)_PN(IS).pdf |
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| author | Sonal Sagar Khatavkar Sravya Bejugama |
| author_facet | Sonal Sagar Khatavkar Sravya Bejugama |
| author_sort | Sonal Sagar Khatavkar |
| collection | DOAJ |
| description | Pierre Robin Sequence (PRS) is characterised by micrognathia, glossoptosis, Cleft Palate (CP) and cardiac defects. The key anaesthetic concerns in managing PRS include the patient’s age, assessment of associated congenital birth defects or syndromes and the potential for a shared airway and anticipated difficult intubation. Intubation should be performed using either a nasal or oral endotracheal tube {Ring-Adair-Elwyn (RAE) or flexometallic} of the appropriate size, with video laryngoscopy or fiberoptic equipment available, if necessary. This toddler, a known case of PRS with a CP, with micrognathia since birth and a history of Dandy-Walker syndrome, presented with complaints of feeding difficulties, growth restriction and recurrent Upper Respiratory Tract Infections (URTIs) since birth. The patient was nebulised and premedicated preoperatively. Induction was achieved with sevoflurane and intubation was performed with a flexometallic tube using fiberoptic guidance due to a Cormack-Lehane grade 3, indicating an anticipated difficult airway. Propofol and the muscle relaxant atracurium were administered and a bilateral maxillary block was provided for postoperative analgesia. The case was managed appropriately throughout induction, intraoperatively and during extubation, with an uneventful postoperative recovery. |
| format | Article |
| id | doaj-art-b15d0efee82e4ebfa053b26094f73fd2 |
| institution | DOAJ |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj-art-b15d0efee82e4ebfa053b26094f73fd22025-08-20T03:06:43ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-03-01193050710.7860/JCDR/2025/75065.20764Pierre Robin Sequence Posted for Palatoplasty: An Anaesthetic and Analgesia ManagementSonal Sagar Khatavkar0Sravya Bejugama1Professor, Department of Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.Junior Resident, Department of Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India.Pierre Robin Sequence (PRS) is characterised by micrognathia, glossoptosis, Cleft Palate (CP) and cardiac defects. The key anaesthetic concerns in managing PRS include the patient’s age, assessment of associated congenital birth defects or syndromes and the potential for a shared airway and anticipated difficult intubation. Intubation should be performed using either a nasal or oral endotracheal tube {Ring-Adair-Elwyn (RAE) or flexometallic} of the appropriate size, with video laryngoscopy or fiberoptic equipment available, if necessary. This toddler, a known case of PRS with a CP, with micrognathia since birth and a history of Dandy-Walker syndrome, presented with complaints of feeding difficulties, growth restriction and recurrent Upper Respiratory Tract Infections (URTIs) since birth. The patient was nebulised and premedicated preoperatively. Induction was achieved with sevoflurane and intubation was performed with a flexometallic tube using fiberoptic guidance due to a Cormack-Lehane grade 3, indicating an anticipated difficult airway. Propofol and the muscle relaxant atracurium were administered and a bilateral maxillary block was provided for postoperative analgesia. The case was managed appropriately throughout induction, intraoperatively and during extubation, with an uneventful postoperative recovery.https://jcdr.net/articles/PDF/20764/75065_CE[Ra1]_F(SL)_PF1(KrA_OM)_redo_PFA(IS)_PN(IS).pdfairway obstructioncleft palatedifficult intubationpaediatric anaesthesiasyndromes |
| spellingShingle | Sonal Sagar Khatavkar Sravya Bejugama Pierre Robin Sequence Posted for Palatoplasty: An Anaesthetic and Analgesia Management Journal of Clinical and Diagnostic Research airway obstruction cleft palate difficult intubation paediatric anaesthesia syndromes |
| title | Pierre Robin Sequence Posted for Palatoplasty: An Anaesthetic and Analgesia Management |
| title_full | Pierre Robin Sequence Posted for Palatoplasty: An Anaesthetic and Analgesia Management |
| title_fullStr | Pierre Robin Sequence Posted for Palatoplasty: An Anaesthetic and Analgesia Management |
| title_full_unstemmed | Pierre Robin Sequence Posted for Palatoplasty: An Anaesthetic and Analgesia Management |
| title_short | Pierre Robin Sequence Posted for Palatoplasty: An Anaesthetic and Analgesia Management |
| title_sort | pierre robin sequence posted for palatoplasty an anaesthetic and analgesia management |
| topic | airway obstruction cleft palate difficult intubation paediatric anaesthesia syndromes |
| url | https://jcdr.net/articles/PDF/20764/75065_CE[Ra1]_F(SL)_PF1(KrA_OM)_redo_PFA(IS)_PN(IS).pdf |
| work_keys_str_mv | AT sonalsagarkhatavkar pierrerobinsequencepostedforpalatoplastyananaestheticandanalgesiamanagement AT sravyabejugama pierrerobinsequencepostedforpalatoplastyananaestheticandanalgesiamanagement |