Anaesthetic management of epidermolysis bullosa

Ames, Warwick A.; Mayou, B.J.; Williams, K. N.

doi:10.1093/bja/82.5.746

Cited by 72 publications

(101 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, its use in patients with DEB has not been widely described in the literature. Ames et al [7] reported it to be safe in patients with epidermolysis bullosa, although in one patient a single new lingual bulla formed. The present patient had a history of multiple episodes of oral bulla formation with rupturing and scarring; thus, we considered tracheal intubation a safer method of airway management than the use of a laryngeal mask airway.…”

Section: Discussionmentioning

confidence: 99%

General anesthesia in a patient with dystrophic epidermolysis bullosa

et al. 2006

View full text Add to dashboard Cite

A 13-year-old boy with epidermolysis bullosa underwent a repair of pseudosyndactyly. He had a long history of bullae formation in the oral cavity and on the pharynx and body surface, and some were active at the time of surgery. We chose inhalational general anesthesia with tracheal intubation using sevoflurane and nitrous oxide. The trachea was successfully extubated after the surgery, and no major bulla formation was observed. General anesthesia with tracheal intubation may be chosen as anesthesia for patients with epidermolysis bullosa.

show abstract

Section: Discussionmentioning

confidence: 99%

General anesthesia in a patient with dystrophic epidermolysis bullosa

et al. 2006

View full text Add to dashboard Cite

show abstract

“…However, ketamine is contraindicated in the presence of hypertension, myocardial insufficiency, psychiatric disorders, or raised intracranial pressure. Also, excitation during recovery may cause further trauma [7]. Thiopentone and propofol have also been used for induction and maintenance of anesthesia [5,7].…”

Section: Discussionmentioning

confidence: 99%

“…Also, excitation during recovery may cause further trauma [7]. Thiopentone and propofol have also been used for induction and maintenance of anesthesia [5,7]. Brachial plexus [1], spinal, and epidural [7,8] blocks in EBD patients have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Thiopentone and propofol have also been used for induction and maintenance of anesthesia [5,7]. Brachial plexus [1], spinal, and epidural [7,8] blocks in EBD patients have been reported. Inhalation induction was the most common method of induction because of difficulty in gaining venous access [5].…”

Section: Discussionmentioning

confidence: 99%

“…Inhalation induction was the most common method of induction because of difficulty in gaining venous access [5]. Sevoflurane suits these patients with rapid induction and recovery [7]. With sevoflurane, unlike halothane, postoperative involuntary movements and shivering are minimal, with less risk of inadvertent trauma [7].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Anesthesia for correction of esophageal stricture in a patient with epidermolysis bullosa: a case report

Çelebi

Pampal

Altuntaş

2000

Journal of Anesthesia

View full text Add to dashboard Cite

different surgical procedures. We could find only two cases of colonic interposition for esophageal stricture with EBD [2,3]. The anesthetic methods were different, and the procedures were shorter than those used in our case. There was only one patient with EBD who underwent a reconstructive operation of 12 h duration [4]. Because of the paucity of the literature on anesthesia of long duration in patients with EBD, we report the anesthetic technique employed in a 12-year-old girl with EBD who underwent a colonic interposition operation of more than 10 h duration. Case reportThe patient was a 12-year-old-girl, 125 cm tall and weighing 24 kg. She had a history of EBD since birth, and she was admitted for investigation of vomiting. A mid-esophageal stricture was shown by barium esophagogram. On physical examination, her body surface was covered with numerous blisters and with fresh and scattered bullae, particularly involving the face, the extensor sides of the extremities, and around the mouth and nose. There was evidence of microstomia, poor dentition, and limited temporomandibular joint mobility. There were also flexion contractures of the fingers of both hands (Fig. 1). The preoperative hemoglobin level was 10.3 g·dl Ϫ1 . Serum electrolytes, protein, and blood urea nitrogen were within normal limits. She had been treated with corticosteroids in the past, but at the time of admission she was taking phenytoin and was applying hydrocortisone ointment 0.5% to her lesions.The patient was taken to the operating room without premedication, and she placed herself on the operating table, which was fitted with cotton rolls. Anesthesia was induced with vital capacity inhalation of sevoflurane in combination with nitrous oxide and oxygen by a disposable face mask. A 25 G intravenous cannula was inserted in the right forearm, and an

show abstract

The use of high‐flow nasal oxygen during airway management in a child with epidermolysis bullosa dystrophica and a difficult airway

Chan

Lam

2019

Anaesthesia Reports

View full text Add to dashboard Cite

Summary The role of high‐flow nasal oxygen in paediatric anaesthesia has been emerging in recent years. However, literature regarding its benefits in paediatric difficult airway management is limited. In this case report, we describe the use of high‐flow nasal oxygen during airway management of a child with a difficult airway due to epidermolysis bullosa dystrophica in whom the use of a facemask would have been potentially harmful. Deep sedation was achieved with propofol and remifentanil while maintaining spontaneous breathing before flexible bronchoscopic tracheal intubation was attempted. However, on attempted tracheal intubation difficulty was encountered due to poor visualisation and contact bleeding. Tracheal intubation was eventually successful after converting to videolaryngoscopy. Oxygenation was maintained throughout the process despite deep sedation and a long procedure time. Moreover, no skin abrasions or mucosal injury resulted from the use of high‐flow nasal oxygen. We conclude that high‐flow nasal oxygen has a valuable role during airway management for a child with a predicted difficult airway when the use of a facemask would have been potentially harmful.

show abstract

Anaesthetic management of epidermolysis bullosa

Cited by 72 publications

References 17 publications

General anesthesia in a patient with dystrophic epidermolysis bullosa

General anesthesia in a patient with dystrophic epidermolysis bullosa

Anesthesia for correction of esophageal stricture in a patient with epidermolysis bullosa: a case report

The use of high‐flow nasal oxygen during airway management in a child with epidermolysis bullosa dystrophica and a difficult airway

Contact Info

Product

Resources

About