Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anesthesia for ankylosing spondylitis (AS) patients with difficult airway is of great stress to anesthesiologists. If tracheal intubation is not mandatory for general anesthesia, laryngeal mask airway (LMA) may suffice for adequate ventilation. Yet, in certain circumstances, no one can guarantee that LMA will reliably serve the purpose in surgical AS patients, especially in operations performed in the lateral decubitus position. We present here an AS patient with difficult airway scheduled for hip surgery. General anesthesia with sevoflurane conveyed by an LMA through spontaneous ventilation in the lateral decubitus position was planned, and the induction was smoothly done. Unfortunately, laryngospasm and oxygen desaturation occurred during the operation; the patient was successfully rescued by nasal intubation with a GlideScope in the lateral decubitus position without interrupting the operation.
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PMID:Emergency tracheal intubation in an ankylosing spondylitis patient in the lateral position using the GlideScope. 1859 54

Ankylosing spondylitis can present significant challenges to the anaesthetist as a consequence of the potential difficult airway, cardiovascular and respiratory complications, and the medications used to reduce pain and control the disease. There is also an increased risk of neurological complications in the peri-operative period. Awake fibreoptic intubation is the safest option in those patients with a potentially difficult airway as it allows continuous neurological monitoring while achieving a definitive airway. Neurophysiological monitoring (somatosensory and motor evoked potentials) should be considered in patients undergoing surgery for cervical spine deformity. The medical management of the disease has improved with the use of anti-tumour necrosis factor-alpha agents. There is potential for increased wound infection in patients taking these drugs. This article reviews the anaesthetic issues in patients with ankylosing spondylitis. The challenge to the anaesthetist is in the understanding of these issues so that appropriate management can be planned and undertaken.
Anaesthesia 2009 May
PMID:Ankylosing spondylitis: recent developments and anaesthetic implications. 1941 25

The Airtraq laryngoscope (AL) is a new single use indirect laryngoscope designed to facilitate tracheal intubation in anaesthetised patients either with normal or difficult airway anatomy. It is designed to provide a view of the glottis without alignment of the oral, pharyngeal and tracheal axes. We report four cases of successful awake tracheal intubation using the AL. The first case is a patient with severe ankylosing spondylitis and the other three cases with anticipated difficult airway. An awake intubation under sedation and topical airway anaesthesia was chosen. We consider that the AL can be used effectively to accomplish an awake intubation in patients with a suspected or known difficult airway and may be a useful alternative where other methods for awake intubation have failed or are not available.
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PMID:Awake tracheal intubation using the Airtraq laryngoscope: a case series. 1996 42

A woman with severe ankylosing spondylitis presented to the preanesthetic clinic before total hip arthroplasty. She had required general anesthesia with fiberoptic intubation after failed attempts at spinal anesthesia for previous hip surgery. Using a portable ultrasound unit, we identified an open L4-5 interlaminar space and offered the patient an ultrasound-guided spinal anesthetic. Dural puncture with a single needle pass was subsequently achieved with the aid of preprocedural ultrasound imaging. Ultrasound may be a useful preoperative assessment tool for assessing the feasibility of central neuraxial blockade when technical difficulty is anticipated.
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PMID:Ultrasonography as a preoperative assessment tool: predicting the feasibility of central neuraxial blockade. 1986 68

The authors present their experience with total hip replacement in patients with ankylosing spondylitis. In the period of 1985-1997 they performed in total 66 total hip replacements in 41 patients. Of the total number of the used implants 24 were fully cemented (the average follow-up - 13 years), 3 were hybrid and 39 cementless (the average follow-up - 6 years). The results of total hip replacements were assessed on the basis of Harris score (HS). The outcomes of the two subgroups, i. e. cemented and cementless implants, were statistically evaluated and compared. The group of hybrid implants was not statistically evaluated due to a small size of the subgroup. In both evaluated groups of implants the results were very favourable (the average HS value in cemented: 86,2 in cementless: 86,4). The occurrence of periarticular ossifications was minimal in both groups. Of the post-operative complications we recorded one case of displacement of the implant which was solved by closed reduction under general anesthesia. Two cases required re-operation of the loosened cementless cup. There occurred no infect. On the basis of the evaluation of the average 13-year results of cemented implants the use of this type of total hip replacement in patients with M. Bechterev is recommended. The question remains whether the same positive values will be produced after the same time interval also by cementless implants as we still do not have results from a 10-year follow-up. Key words: ankylosing spondylitis, total hip replacement.
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PMID:[Total hip replacement in patients with ankylosing spondylitis.]. 2047 23

We describe a patient with long-standing ankylosing spondylitis who underwent percutaneous nephrolithotomy under spinal anesthesia. At preoperative assessment, it was considered that intubation of the trachea was likely to be difficult. Fiberoptic bronchoscopy was attempted, but without success. As the standard technique for spinal anesthesia failed, a variation of the paramedian approach in the lumbosacral approach, also known as Taylor's approach was successfully attempted. This resulted in adequate sensory and motor blockade for the surgical procedure. The patient did not require airway interventions, but equipment and aids to secure airway were available.
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PMID:Taylor's approach in an ankylosing spondylitis patient posted for percutaneous nephrolithotomy: A challenge for anesthesiologists. 2053 10

A 73-year-old man suffering from ankylosing spondylitis with limited motion of the whole spine was scheduled for right total hip arthroplasty. Ten years before, the patient had undergone left total hip arthroplasty under general anesthesia, in which epidural anesthesia impossible, intrathecal anesthesia insufficient, and tracheal intubation difficult. In the present operation, an 18 gauge epidural catheter was inserted into the epidural space at L3-4 using paramedian approach. Six ml of contrast medium was administered via the catheter, with high resistance on injection and the spread of epidural contrast medium was limited to L2 and L3. Therefore, the catheter was removed and reinserted into the intrathecal space at L3-4. Two ml of contrast medium demonstrated good spread in the intrathecal space from T12 to S2. Next injection of 0.5% isobaric bupivacaine 2.4ml produced bilateral cold sensory blockade from T10 to S5. Two hours after this injection, a single bolus of 1 ml followed by a continuous infusion at a rate of 0.5 ml x hr(-1) with 0.5% isobaric bupivacaine was commenced. There was no pain at rest and on movement, and no additional analgesics and hypertensive drugs were used until 4 hours following the discontinuation of the continuous intrathecal anesthesia in the morning after the operation. No adverse events including post-dural puncture headache were observed. Continuous intrathecal anesthesia may be effective for total hip arthroplasty in patients with ankylosing spondylitis.
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PMID:[Continuous intrathecal anesthesia for total hip arthroplasty in a patient with ankylosing spondylitis]. 2071 34

The Airway Scope (AWS) provides better glottic view than the conventional direct laryngoscopy in tracheal intubation. With it, the endotracheal tube can be more easily inserted into the tracheal lumen easily. We hereby presented a 24-year-old ankylosing spondylitis (AS) patient wearing a halo vest who was successfully intubated for undergoing cervical spine surgery involving C1 and C2 under general anesthesia. Pre-operative airway assessment revealed that he was a case of difficult intubation. An AWS was used for oral tracheal intubation which was achieved smoothly in the first attempt. AWS can be an alternative device for airway management in a patient wearing halo vest.
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PMID:Pentax-airway scope for tracheal intubation breaks through the limitation of neck motion in an ankylosing spondylitis patient wearing halo vest--a case report. 2119 90

Ankylosing spondylitis presents challenges for the obstetric anesthesiologist in administering neuraxial anesthesia or managing the airway. A pregnant patient with ankylosing spondylitis, cardiomyopathy and preeclampsia requiring cesarean delivery was managed with an awake nasotracheal fiberoptic intubation. The use of topical cocaine, epinephrine, phenylephrine, and oxymetazoline to produce nasal vasoconstriction is discussed. Selective alpha-2 agonists that can potentially provide nasal mucosa vasoconstriction and placental vasculature vasodilation are also discussed.
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PMID:Topical vasoconstrictor use for nasal intubation during pregnancy complicated by cardiomyopathy and preeclampsia. 2131 77

Management of a case of ankylosing spondylitis can be very challenging when the airway and the central neuraxial blockade, both are difficult. Ultrasound-assisted central neuraxial blockade may lead to predictable success in the field of regional anaesthesia. We present a young patient with severe ankylosing spondylitis where conventional techniques failed and ultrasound helped in successful combined spinal-epidural technique for total hip replacement surgery.
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PMID:Management of a case of ankylosing spondylitis for total hip replacement surgery with the use of ultrasound-assisted central neuraxial blockade. 2371 71


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