Anesthetic management with subcostal transversus abdominis plane block in recessive dystrophic epidermolysis bullosa for peritoneal dialysis catheter replacement: a case report

Abstract

Background: Recessive dystrophic epidermolysis bullosa (RDEB) is a rare, hereditary mucocutaneous disorder that can involve renal insufficiency. If a vascular access for hemodialysis is unavailable, peritoneal dialysis can be utilized. This report describes an anesthetic management with ultrasound-guided transversus abdominis plane block (TAPB) in a patient with RDEB for peritoneal dialysis catheter replacement. Case presentation: A 49-year-old woman with RDEB needed to undergo peritoneal dialysis catheter replacement. As general, neuraxial and local infiltration anesthesia can lead to serious complications; we planned anesthetic management with subcostal TAPB as the primary analgesia modality. In the operating theater, surgery was initiated after performing left-sided subcostal TAPB. The patient complained of moderate pain at some points during surgery, and the pain was controlled with intravenous or local anesthetics without serious complications. Conclusions: In summary, subcostal TAPB could be a useful option for peritoneal dialysis catheter surgery in patients with RDEB.

Role of regional anaesthesia in a patient with epidermolysis bullosa dystrophica for emergency surgery

“…Avoiding airway manipulation and instrumentation prevented the spontaneous blisters development in the airway tract, thereby reducing morbidity. [ 2 ] Adequate analgesia is mandatory as children tend to roll around the table leading to skin trauma and blisters development. [ 3 ] Caudal block made the procedure opioid-free as it can lead to pruritus.…”