<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8771</journal-id>
<journal-title><![CDATA[Anestesia en México]]></journal-title>
<abbrev-journal-title><![CDATA[Anest. Méx.]]></abbrev-journal-title>
<issn>2448-8771</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Anestesiología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-87712018000100048</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Anestesia regional guiada por fluoroscopia en paciente con Síndrome de Morquio: Reporte de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Regional anesthesia guided by fluoroscopy in a patient with Morquio Syndrome: Case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rosa Moya]]></surname>
<given-names><![CDATA[Griselda De la]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ávila-López]]></surname>
<given-names><![CDATA[Armando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ándrade Fouchet]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional ]]></institution>
<addr-line><![CDATA[ Veracruz]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional ]]></institution>
<addr-line><![CDATA[ Veracruz]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional ]]></institution>
<addr-line><![CDATA[ Veracruz]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<volume>30</volume>
<numero>1</numero>
<fpage>48</fpage>
<lpage>54</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-87712018000100048&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-87712018000100048&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-87712018000100048&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Las mucopolisacaridosis son enfermedades genéticas hereditarias, poco comunes. El síndrome de Morquio es un trastorno autosómico recesivo. Su prevalencia es de 200,000-250,000 nacidos vivos. El cuadro clínico se caracteriza por inteligencia conservada, múltiples anormalidades esqueléticas, enanismo, tórax en tonel, pectus carinatum, hiperlaxitud articular, hipoplasia de odontoides, cifoescoliosis, mielopatia cervical, prognatismo, valvulopatías, cuello corto, macroglosia, apertura bucal restringida, considerándolos pacientes con vía aérea difícil.  Caso Clínico: Femenino de 31 años de edad con diagnóstico de síndrome Morquio y fractura supracondílea de fémur derecho. Antecedente de asma, quirúrgicos positivos. Valoración cardiológica reporta fracción de eyección 72%, insuficiencia tricuspídea y aórtica leves. Exploración física: talla baja, IMC 49.4%, facies características, tórax carinatum, escoliosis. Se realiza anestesia regional lumbar guiada por fluoroscopia, en posición de sedestación bajo técnica de bloqueo habitual, nivel L1-L2, se administra ropivacaina y fentanilo subaracnoideo.  Discusión: Los pacientes con síndrome de Morquio condicionan un complicado manejo de la vía aérea, las técnicas regionales ofrecen ventajas en el control hemodinámico y manejo del dolor postoperatorio con una recuperación favorable sin complicaciones catastróficas que pongan en riesgo la vida. La anestesia regional guiada por fluoroscopia no es una técnica habitual pero si una alternativa en pacientes con alteraciones anatómicas complejas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The mucopolysaccharidoses are rare genetic diseases. Morquio syndrome (MPS type IV) is an autosomal recessive inheritance disorder, with a prevalence of 200,000 - 250,000 live births. Characterized by normal intelectual development, several skeletal involvement included short stature, shortened trunk and neck, precuts carinatum, joint laxity, odontoid dysplasia, kyphoscoliosis, cervical cord compression, prognathism, valvular heart disease, macroglossia, restricted mouth opening, considering them difficult airway patients.  Case presentation: 31 year old female with Morquio syndrome and right supracondylar femur fracture. History of asthma and ortopedic surgery. Cardiological assessment with left ventricle ejection fraction 72%, tricuspid and aortic mild regurgitation. Physical exam: Short stature, BMI 49.4, characteristic facies, pectus carinatum and scoliosis. Spinal lumbar anesthesia with fluoroscopic guidance was performed on sitting position under standard technique, L1-L2 level, subarachnoid ropivacaine and fentanyl was administrated.  Discussion: Morquio syndrome patients represent complex airway management, regional anesthesia techniques offers advantages in set of hemodynamic control and postoperative pain management with favorable recovery features without catastrophic complications. Regional anesthesia with fluoroscopic guidance is not a common technique but it&#8217;s an alternative for patients with complex anatomic abnormalities.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[síndrome de Morquio]]></kwd>
<kwd lng="es"><![CDATA[mucopolisacaridosis]]></kwd>
<kwd lng="es"><![CDATA[anestesia regional]]></kwd>
<kwd lng="en"><![CDATA[Morquio syndrome]]></kwd>
<kwd lng="en"><![CDATA[mucopolysaccharidosis]]></kwd>
<kwd lng="en"><![CDATA[regional anaesthesia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Spinello]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Novello]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Pitino]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Raiti]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Murabito]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Stimoli]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Astuto]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anesthetic management in mucopolysaccharidoses]]></article-title>
<source><![CDATA[ISRN Anesthesiology]]></source>
<year>2013</year>
<page-range>1-10</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hendriksz]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Berger]]></surname>
<given-names><![CDATA[KI]]></given-names>
</name>
<name>
<surname><![CDATA[Giugliani]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Harmatz]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Kampmann]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Mackenzie]]></surname>
<given-names><![CDATA[WG]]></given-names>
</name>
<name>
<surname><![CDATA[Raiman]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Villarreal]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Savarirayan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[International guidelines for the management and treatment of Morquio A syndrome]]></article-title>
<source><![CDATA[Am J Med Genet]]></source>
<year>2015</year>
<volume>167A</volume>
<page-range>11-25</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Solanki]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Theroux]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Lampe]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[White]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Shediac]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spinal involvement in mucopolysaccharidosis IVA (Morquio-Brailsford or Morquio A syndrome) presentation, diagnosis and management]]></article-title>
<source><![CDATA[J Inherit Metab Dis]]></source>
<year>2013</year>
<volume>36</volume>
<page-range>339-55</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kadic]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Driessen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[General anaesthesia in an adult patient with Morquio syndrom with emphasis on airway issues]]></article-title>
<source><![CDATA[Bosn J Basic Med Sci]]></source>
<year>2012</year>
<volume>12</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>130-3</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pagel]]></surname>
<given-names><![CDATA[PS]]></given-names>
</name>
<name>
<surname><![CDATA[Almassi]]></surname>
<given-names><![CDATA[GH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perioperative implications of Morquio síndrome in a 31-year-old woman, undergoing aortic valve replacement]]></article-title>
<source><![CDATA[J. Cardiothorac Vasc. Anesth]]></source>
<year>2009</year>
<volume>23</volume>
<page-range>855-7</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mahajan]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Adarsha]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Jena]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Srivastava]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anaesthetic implications in a patient with Morquio A syndrome]]></article-title>
<source><![CDATA[J Neuroanaesthesiol Crit Care]]></source>
<year>2015</year>
<volume>2</volume>
<page-range>130-3</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tomatsu]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Obstructive airway in Morquio A syndrome, the past, the present and the future]]></article-title>
<source><![CDATA[Mol. Genet. Metab]]></source>
<year>2015</year>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Drummond]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Krane]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
<name>
<surname><![CDATA[Tomatsu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Theroux]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Paraplegia after epidural-general anesthesia in a Morquio patient with moderate thoracic spinal stenosis]]></article-title>
<source><![CDATA[Can J Anaesth]]></source>
<year>2015</year>
<volume>62</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>45-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Theroux]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Nerker]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Ditro]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Mackenzie]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anesthetic care and perioperative complications of children with Morquio síndrome]]></article-title>
<source><![CDATA[Pediatric Anesthesia]]></source>
<year>2012</year>
<volume>22</volume>
<page-range>901-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
