DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20150958

Anesthesia management of patient with achondroplasia for abdominal hysterectomy

Asmita P. Karnalkar, Ashok Deshpande

Abstract


Achondroplasia is the commonest form of dwarfism. These patients present several problems for both general and regional anesthesia. There are reports describing regional anesthesia in such patients but there are scarce reports of general anesthesia. The aim of this report is to discuss anesthetic considerations in such patients and to emphasize the difficulties encountered. A 34 year old patient with achondroplasia underwent abdominal hysterectomy under general anesthesia supplemented with regional analgesia. Since preoperative assessment suggested difficult airway, regional anesthesia was planned which was not successful due to spinal abnormality. Subsequently general anesthesia was established with Laryngeal Mask Airway (LMA) with controlled ventilation without any complication.


Keywords


Achondroplasia, Laryngeal mask airway

Full Text:

PDF

References


Berkowitz ID, Raja SN, Bender KS, Kopits SE. Dwarfs: pathophysiology and anaesthetic implications. Anaesthesiology. 1990;73:739-59.

Derenzo JS, Vallejo MC, Ramanathan S. Failed regional anaesthesia in a parturient with achondroplasia presenting for urgent caesarean section. Int J Obstet Anaesth. 2005;14(2):175-8.

Kempthorne PM, Brown TCK. Anaesthesia and the mucopolysaccharidoses: a survey of techniques and problems. Anaesth Intensive Care. 1983;11:203-7.

Mather JS. Impossible direct laryngoscopy in achondroplasia. Anaesthesia. 1966;21:244-8.

Jones AEP, Croley TF. Morquio syndrome and anaesthesia. Anaesthesiology. 1979;51:261-2.

Bergstrom K, Lorent U. Neurological symptoms in achondroplasia. Acta Neurol Scand. 1971;47:59-70.

Buroisin RC, Yahr MD. Compressive spinal cord and root syndromes in achondroplasia. Neurology. 1962;12:202-7.

Wynne Davis R, Walsh WK. Achondroplasia and hypochondroplasia. Clinical variation and spinal stenosis. J Bone Joint Surg. 1981;63B:508-15.

Roland Miller. Anesthesia for orthopaedic surgery. In: Ronald D. Miller, Lars I. Eriksson, Lee A Fleisher, Jeanine P. Wiener-Kronish, Neal H. Cohen, William L. Young, eds. Textbook of Anesthesia. 8th ed. Philadelphia: Saunders; 2014.

Brimacombe JR. Laryngeal mask anesthesia. Principle and practice. In: Brimacombe JR, eds. A Book. 2nd ed. London: W B Saunders; 2005.

Brimacombe J, Berry A. The incidence of aspiration with laryngeal mask anesthesia. J Clin Anesth. 1995;7:297-305.

American Society of Anesthesiologists Taskforce on Management of the Difficult Airways. Practice guidelines for management of the difficult airway. An updated report. Anesthesiology. 2003 May;98:1269-77.