Anesthesia in Cerebral Palsy.ppt

Anesthesia in Cerebral Palsy R i 鄭玠峰、林鉉智 Directed by R3 林子富 VS 范守仁 《Part 1》 Case Presentation Brief history 蔡╳╳ 3-year 7-month-old boy Chief Complain Dyspnea with fever for 2 days Present Illness ?3-year 7-month-old boy ?Cerebral palsy secondary to Reye’s syndrome ?Multiple episodes of aspiration pneumonia and acute bronchiolitis ?Dyspnea with fever was noted, for further evaluation. Brief History Birth history： G3P3, C/S due to twin pregnancy, Twin B GA=36+ weeks, BBW=2416 gm Vaccination： BCG1, HBV3, DPT Polio, Measles, MMR,JVE, Varicella (as scheduled) Feeding： on full diet Growth Development Body weight=12 Kg (3 percentile) DMS：Developmentally delay Gross motor：Cannot stand or jump Fine motor： Putting on clothes (-) Wearing shoes (-) Feeding with spoon (-) Verbal：Just nonsense murmuring voice Past History (1) 881026~881028: 婦幼H for suspected TTNB (2) 890511~890530: NTUH for Reye-like syndrome, r/o fatty acid oxidation defect (3) 890719~890901: NTUH for acute bronchitis, respiratory failure (4) 890906~890922: NTUH for aspiration pneumonia (5) 890923~890928: NTUH for upper GI bleeding (6) 891105~891118: NTUH for aspiration pneumonia (7) 891121~891219: NTUH for aspiration pneumonia (8) 891226~900113: NTUH for cellulitis (9) 900208~900215: NTUH for acute bronchiolitis (10) 900503~900601: NTUH for AGE, UTI, and pneumonia (11) 900627~900622: bronchopneumonia (12) 900707~900712: NTUH for acute bronchiolitis (13) 900806~900812: NTUH for aspiration pneumonia Past History (14) 901008~901016: NTUH for RSV bronchiolitis (15) 901020~901105: NTUH for acute bronchiolitis (16) 901108~901111: NTUH for laryngomalacia Bilateral retracted testes and hydrocele, s/p flexible bronchoscope, rigid bronchoscope bilateral orchiopexy (17) 910626~910703: NTUH for aspiration pneumonia (18) 910713~910718: NTUH for bronchiolitis (19) 911122~911128: NTUH for acute bronchiolitis (20) 920424~920502: NTUH for acute bronchiolitis (21) 9