From the Research
The recommended anesthesia plan for a patient with Sjögren's disease should prioritize meticulous management of xerostomia and keratoconjunctivitis sicca, with a focus on maintaining hydration, using lubricants, and protecting the eyes and airway. When managing a patient with Sjögren's disease, it is crucial to consider the disease's key manifestations, particularly xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes) 1. Preoperatively, maintaining adequate hydration and continuing the patient's regular medications, including artificial tears and saliva substitutes, is essential 2. During the preoperative assessment, evaluating for potential difficult airway management due to dry mucous membranes and assessing for associated conditions like rheumatoid arthritis or systemic lupus erythematosus is vital 3. For induction and maintenance, standard anesthetic agents can be used, but careful attention should be paid to airway management, with liberal application of water-based lubricants to the endotracheal tube to prevent trauma to dry mucous membranes 4. Some key points to consider in the anesthesia plan include:
- Maintaining adequate hydration throughout the procedure
- Protecting the eyes with lubricating ointment and taping them closed to prevent corneal abrasions
- Providing humidified oxygen postoperatively
- Ensuring adequate pain management
- Encouraging early mobilization, especially in patients with associated rheumatologic conditions 5. This approach addresses the primary concerns of mucosal dryness while preventing complications related to the disease's systemic manifestations, ultimately prioritizing the patient's morbidity, mortality, and quality of life 1.