Osteogenesis imperfecta (OI) is a rare disabling genetic connective tissue disorder. General anesthesia in these patients is associated with increased risks. ⋯ We are reporting the use of combined spinal-epidural anesthesia for a prolonged surgery (multiple osteotomies) of lower limbs in a 10-year-old wheelchair-bound child with OI type III. Preoperative counseling, ultrasonography guidance, titrated local anesthetic dosage, and dexmedetomidine sedation helped establish optimum surgical conditions.
Anju Gupta, Geeta Kamal, Nishkarsh Gupta, and Anil Aggarwal.
From the *Department of Anesthesiology, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, India; †Department of Onco-Anesthesiology and Pain Medicine, DRBRAIRCH, AIIMS, New Delhi, India; and ‡Departme... more nt of Orthopedics, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, India. less
A A Case Rep. 2017 Jul 15; 9 (2): 60-63.
AbstractOsteogenesis imperfecta (OI) is a rare disabling genetic connective tissue disorder. General anesthesia in these patients is associated with increased risks. Regional anesthesia is favored wherever feasible, but there are limited reports of use of a sole regional technique in OI in pediatric patients. Moreover, combined spinal-epidural anesthesia has never been described previously. We are reporting the use of combined spinal-epidural anesthesia for a prolonged surgery (multiple osteotomies) of lower limbs in a 10-year-old wheelchair-bound child with OI type III. Preoperative counseling, ultrasonography guidance, titrated local anesthetic dosage, and dexmedetomidine sedation helped establish optimum surgical conditions.