Anaesthesia in arthrogryposis multiplex congenita: Case report

Regional anesthesia with a single spinal anesthesia using hyperbaric bupivacaine in a child with arthroglyposis multiplex congenita

“…The limited mouth opening in patients with AMC can be severe and may make direct laryngoscopy impossible, as in our patient [8]. In addition to these problems, these patients are prone to hypotension, respiratory depression, diminution of muscle tone, and prolonged action of various inhalational and intravenous anesthetic drugs [7]. There may be postoperative airway and respiratory issues with AMC.…”

“…The most common maxillofacial findings reported include decreased mandibular opening, micrognathia, and high arched palate [6]. Of primary concern to the anesthesiologist is the potential for airway involvement, thereby making direct laryngoscopy and endotracheal intubation difficult [7]. Steinberg et al [6] reviewed the findings in 23 patients with AMC and noted a 22% incidence of maxillofacial involvement with limited mouth opening in 3 of the 23 patients.…”

“…Scoliosis has been reported in up to 65% of patients with AMC [9,10]. These problems also may result in alveolar hypoventilation, restrictive respiratory pattern, and postoperative atelectasis [7]. Patients with AMC may tend to show higher sensitivity to muscle relaxants [1].…”

Ex utero intrapartum treatment procedure in a patient with arthrogryposis multiplex congenita, using continuous spinal anesthesia and intravenous nitroglycerin for uterine relaxation

“…To date there are only three reports in the literature of anesthetics administered to parturients with AMC. [9][10][11] There are numerous anesthetic concerns in a parturient with AMC. Intravenous access may be difficult due to contractures.…”

Anesthesia for arthrogryposis multiplex congenita

“…Oberoi et a1. 9 recommended the use of ketamine anesthesia for a patient with AMC because of its relative lack of respiratory and cardiovascular depressive effects. On the other hand, a patient with AMC who produced copious orophangeal secretions has been reported".…”