CONSIDERACIONES ANESTÉSICAS EN LA ESPONDILITIS ANQUILOSANTE. A PROPÓSITO DE UN CASO Y REVISIÓN DE LA BIBLIOGRAFÍA.

Ruby Molina Villaverde

Enviado octubre 27, 2024

Publicado 2026-04-06

Artículos de Investigación

Vol. 19 Núm. 2 (2006): Revista Médico Científica

CONSIDERACIONES ANESTÉSICAS EN LA ESPONDILITIS ANQUILOSANTE. A PROPÓSITO DE UN CASO Y REVISIÓN DE LA BIBLIOGRAFÍA.

Ruby Molina Villaverde⁺⁻

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DOI: ND

Publicado: 2026-04-06

Derechos de autor 2024 Revista médico científica

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.

Resumen

La espondilitis anquilosante, entidad reumatológica poco frecuente, es una artritis inflamatoria de la columna que involucra las articulaciones sacroiliacas. Con frecuencia también se afectan articulaciones periféricas, llegando a requerirse cirugías ortopédicas mayores como el reemplazo de rodilla.

Se presenta el caso de una joven con espondilitis avanzada, quien requirió de dicho procedimiento y por lo tanto intervención anestésica especial. La evaluación preanestésica mostraba claros predictores de dificultad para el manejo de la via aérea y para la aplicación de técnicas anestésicas regionales. Las deformidades no le permitían el reposo horizontal supino completo. Se decidió llevar a cabo anestesia general, luego de intubación con fibroscopia óptica dada la peculiaridad de su vía aérea. Se aprovecha la oportunidad para discutir los hallazgos y complicaciones de esta enfermedad que pueden dificultar el manejo perioperatorio, asi como la importancia de la visita preanestésica, y las modalidades propuestas para el manejo anestésico de estos pacientes.

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Wittmann F, Ring P. Anaesthesia for hip replacement in ankylosing spondylitis. J R Soc Med 1986; 79: 457-9.
Stafford L, Youssef P. Spondyloarthropathies: an overview. Intern Med J 2002; 32: 40-6.
Reveille J, Arnett F. Spondyloarthritis: update on pathogenesis and management. The American Journal of Medicine. 2005; 118:592- 603.
Sharrock N, Beckman J, Connolly E, Savarese J. Anesthesia for Orthopedic Surgery. Miller's Anesthesia Philadelphia. Churchill Livingstone Inc.; 2005: 2411.
Rosenberg A. Current issues in the anesthetic treatment of the patient for orthopedic surgery. Lippincott Williams & Wilkins 2004 The American Society of Anesthesiologists, cap 15 vol 32.
Cullen O, Bogdanov E, Htut N. Spinal epidural hematoma occurrence in the absence of known risk factors: a case series. J Clin Anesth 2004; 16:376-81.
Chen I, Chien J, Yu T. Transpedicular wedge osteotomy for correction of thoracolumbar kyphosis in ankylosing spondylitis experience with 78 patients. Spine 2001;26(16):354-60.
Chang K, Chen Y, Lin C, Hsu H, Pai K. Closing wedge osteotomy versus opening wedge osteotomy in ankylosing spondylitis with thoracolumbar kyphotic deformity. Spine 2005; 30(14):1584-93
Zochling J, D van der Heijde, Dougados M, Braun J. Current evidence for the management of ankylosing spondylitis: a systematic literature review for the ASAS/EULAR management recommendations in ankylosing spondylitis. Ann Rheum Dis 2006;65:423-32.
Huffer L, Furgerson J. Aortic root dilatation with sinus of valsalva and coronary artery aneurysms associated with ankylosing spondylitis. Tex Heart Inst J 2006;33 (1) 70-3.
Roldan C, Chavez J, Wiest P,Qualls C, Crawford M. Aortic root disease and valve disease associated with ankylosing spondylitis. J Am ColI Cardiol 1998; 32(5):1397-404.
Blanda M, Gallo U. Emergency airway management. Emergency Medicine Clinics of North America 2003; 21:1-26
Lu P, Brimacombe J, Ho A, Shyr M, Liu H. The intubating laryngeal mask airway in severe ankylosing spondylilis. Canadian Journal of Anesthesia, 2001; 48(10): 1015-19.
Roberts K, Solgonick, R. A modification of retrograde wire-guided, fiberoptic-assisted endotracheal intubation in a patient with ankylosing spondylitis. Anesth Analg [Case Reports] 1996; 82(6): 1290-1.
Watkinson JC. Stridor in rheumatoid arthritis may be caused by laryngeal amyloidosis. BMJ 1996; 312:1227.
Shen F, Samartzis D. Cervical spine fracture in the ankylosing spondylitis patient. J Am Coll Surg 2005; 200(4): 632-3.
Sharrock N, Cazan M, Hargett M, Williams-Russo P, Wilson P. Changes in mortality after total hip and knee arthroplasty over a ten-year period. Anesth Analg 1995; 80(2):242-8.
Williams-Russo P, Sharrock N, Haas S, Insall J, Windsor R, Laskin R et al. Randomized trial of epidural versus
general anesthesia: outcomes after primary total knee replacement. Clin Orthop Relat Res 1996 (331):199-208.
Lee L, Posner K, Domino K. Injuries associated with regional anesthesia in the 1980s and 1990s. Anesthesiology 2004;101:143-52.
Moen V, Dahlgren N, Irestedt L. Severe neurological complications after central neuraxial blockades in Sweden
-1999. Anesthesiology 2004; 101:950-9.
Mehrotra S, Gupta K. Cesarean section in a patient with advanced ankylosing spondylitis. Int J Gyna ecol Obst
; 89: 272-3.
George E, Haspel K. The difficult airway. Int Anesthesiol Clin 2000; 38(3):47-63.
Duggan M, Kavanagh B. Pulmonary atelectasis: a pathogenic perioperative entity. Anesthesiology 2005; 102(4):838-54.
Zochling J, Braun J. Management and treatment of ankylosing spondylitis. Curr Opin Rheumatol 2005; 17:418-25
Davies A, Segar E, Murdoch J, Wright O, Wilson I. Epidural infusion or combined femoral and sciatic nerve blocks as perioperative analgesia for knee arthroplasty. Br J Anaesth 2004; 93 (3):368-74.

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[1] Wittmann F, Ring P. Anaesthesia for hip replacement in ankylosing spondylitis. J R Soc Med 1986; 79: 457-9.

[2] Stafford L, Youssef P. Spondyloarthropathies: an overview. Intern Med J 2002; 32: 40-6.

[3] Reveille J, Arnett F. Spondyloarthritis: update on pathogenesis and management. The American Journal of Medicine. 2005; 118:592- 603.

[4] Sharrock N, Beckman J, Connolly E, Savarese J. Anesthesia for Orthopedic Surgery. Miller's Anesthesia Philadelphia. Churchill Livingstone Inc.; 2005: 2411.

[5] Rosenberg A. Current issues in the anesthetic treatment of the patient for orthopedic surgery. Lippincott Williams & Wilkins 2004 The American Society of Anesthesiologists, cap 15 vol 32.

[6] Cullen O, Bogdanov E, Htut N. Spinal epidural hematoma occurrence in the absence of known risk factors: a case series. J Clin Anesth 2004; 16:376-81.

[7] Chen I, Chien J, Yu T. Transpedicular wedge osteotomy for correction of thoracolumbar kyphosis in ankylosing spondylitis experience with 78 patients. Spine 2001;26(16):354-60.

[8] Chang K, Chen Y, Lin C, Hsu H, Pai K. Closing wedge osteotomy versus opening wedge osteotomy in ankylosing spondylitis with thoracolumbar kyphotic deformity. Spine 2005; 30(14):1584-93

[9] Zochling J, D van der Heijde, Dougados M, Braun J. Current evidence for the management of ankylosing spondylitis: a systematic literature review for the ASAS/EULAR management recommendations in ankylosing spondylitis. Ann Rheum Dis 2006;65:423-32.

[10] Huffer L, Furgerson J. Aortic root dilatation with sinus of valsalva and coronary artery aneurysms associated with ankylosing spondylitis. Tex Heart Inst J 2006;33 (1) 70-3.

[11] Roldan C, Chavez J, Wiest P,Qualls C, Crawford M. Aortic root disease and valve disease associated with ankylosing spondylitis. J Am ColI Cardiol 1998; 32(5):1397-404.

[12] Blanda M, Gallo U. Emergency airway management. Emergency Medicine Clinics of North America 2003; 21:1-26

[13] Lu P, Brimacombe J, Ho A, Shyr M, Liu H. The intubating laryngeal mask airway in severe ankylosing spondylilis. Canadian Journal of Anesthesia, 2001; 48(10): 1015-19.

[14] Roberts K, Solgonick, R. A modification of retrograde wire-guided, fiberoptic-assisted endotracheal intubation in a patient with ankylosing spondylitis. Anesth Analg [Case Reports] 1996; 82(6): 1290-1.

[15] Watkinson JC. Stridor in rheumatoid arthritis may be caused by laryngeal amyloidosis. BMJ 1996; 312:1227.

[16] Shen F, Samartzis D. Cervical spine fracture in the ankylosing spondylitis patient. J Am Coll Surg 2005; 200(4): 632-3.

[17] Sharrock N, Cazan M, Hargett M, Williams-Russo P, Wilson P. Changes in mortality after total hip and knee arthroplasty over a ten-year period. Anesth Analg 1995; 80(2):242-8.

[18] Williams-Russo P, Sharrock N, Haas S, Insall J, Windsor R, Laskin R et al. Randomized trial of epidural versus

[19] general anesthesia: outcomes after primary total knee replacement. Clin Orthop Relat Res 1996 (331):199-208.

[20] Lee L, Posner K, Domino K. Injuries associated with regional anesthesia in the 1980s and 1990s. Anesthesiology 2004;101:143-52.

[21] Moen V, Dahlgren N, Irestedt L. Severe neurological complications after central neuraxial blockades in Sweden

[22] -1999. Anesthesiology 2004; 101:950-9.

[23] Mehrotra S, Gupta K. Cesarean section in a patient with advanced ankylosing spondylitis. Int J Gyna ecol Obst

[24] ; 89: 272-3.

[25] George E, Haspel K. The difficult airway. Int Anesthesiol Clin 2000; 38(3):47-63.

[26] Duggan M, Kavanagh B. Pulmonary atelectasis: a pathogenic perioperative entity. Anesthesiology 2005; 102(4):838-54.

[27] Zochling J, Braun J. Management and treatment of ankylosing spondylitis. Curr Opin Rheumatol 2005; 17:418-25

[28] Davies A, Segar E, Murdoch J, Wright O, Wilson I. Epidural infusion or combined femoral and sciatic nerve blocks as perioperative analgesia for knee arthroplasty. Br J Anaesth 2004; 93 (3):368-74.

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