A rare case of Stevens- Jonhson Syndrome with attention deficit hyperkinetic disorder and seizure disorder for circumcision: An anesthetic challenge

Chowdhury, Deepasri; Khatavkar, Sonal; Samuel, Mary

doi:10.4103/0975-2870.197900

Cited by 2 publications

(1 citation statement)

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“…In other studies, ketamine was used as the sole anesthetic agent for small surgical procedures. [ 15 16 18 19 ] Propofol may cause precipitous fall in blood pressure in hypovolemic patients if not used in titrated doses. Ketamine has the added advantages of analgesic effect, preservation of the protective airway reflexes and maintenance of spontaneous respiration.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management and outcomes of patients with Steven-Johnson Syndrome—A retrospective review study

Ramsali¹,

Puduchira²,

Maganti³

et al. 2021

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: Steven-Johnson Syndrome (SJS) is a rare and severe form of erythema exudative multiforme. Multisystem involvement in SJS and the suspicion of precipitation of the disease with exposure to anesthetic drugs makes anesthesia a challenging task. The concerns during anesthesia are the mucosal lesions and special care that is required to prevent injury to the oropharynx and larynx during airway management and also the drugs used for anesthesia. In the literature, very few isolated case reports or case series are available. Here, we have analyzed the cases of SJS coming for ophthalmic anesthesia, taking into consideration factors like mode of presentation, precipitating factors, associated diseases, types of anesthesia, anesthetic modifications, and various drugs used during anesthesia. Material and Methods: The electronic medical records of 497 cases of SJS who required interventions like ophthalmic examination or surgery (either under local or general anesthesia) over a period of 18 months were analyzed retrospectively. The records were reviewed to obtain the concerned details like anesthesia-inducing agents, muscle relaxants, inhalational agents, and analgesics. The problems concerned with monitoring and intubation were also noted. The data were analyzed and presented as frequency and percentage. Results: Patient age ranged between 9 months and 72 years. Many surgeries were conducted under general anesthesia (441) although a few required local (peribulbar block) anesthesia (56). The drugs administered for general anesthesia were sevoflurane, isoflurane, propofol, thiopentone, vecuronium, and atracurium and those administered for pain management were fentanyl, tramadol, butorphanol, and paracetamol. The patients who were sensitive to nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol were not administered the same. None of the patients reacted adversely to the different drugs used for anesthesia. Conclusion: Identifying the precipitating factors, understanding the pathophysiology and its implications for anesthesia will help in successfully managing anesthesia in the rare cases of SJS.

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