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

Borazan, Hale; Uluer, Mehmet Selçuk; Şahin, O.; Ökesli, Selmin

doi:10.1007/s00540-011-1309-y

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…The use of indwelling catheters can help control postoperative surgical pain and pain during aggressive postoperative passive range of motion therapy. 14 While successful spinal anesthesia has been reported in children with limb 15 fractures and for affected adults during caesarean section and ex utero intrapartum treatment, there are concerns given the high frequency of vertebral column deformities in arthrogryposis. 16 The use of regional anesthesia does not obviate the need to have careful planning for airway management in the event of failed or incomplete block.…”

Section: Management Of the Patient With Arthrogryposismentioning

confidence: 99%

Difficult airway management in children and young adults with arthrogryposis

Isaacson¹,

Drum

2018

World j. otorhinolaryngol.-head neck surg.

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ObjectiveTo review current evidence and experience with anesthesia and airway management issues in children and young adults with arthrogryposis.Data sourcesReview of existing world literature and description of personal experience at a center for children's orthopedic surgery and rehabilitation over 2 decades.MethodsDescription of common problems and their solutions in this unusual and diverse group of patients.ResultsArthrogryposis multiplex congenital includes more than 400 conditions that lead to congenital joint contractures affecting more than one body area. Among the many causes of arthrogryposis, 50%–65% fall into two large categories – amyoplasia and distal arthrogryposis. There is general agreement that best function in children with arthrogryposis is achieved through early mobilization of joint contractures. Children with arthrogryposis average >5 operative procedures during childhood. Anesthesia for these procedures may be complicated by limited jaw mobility and mouth opening, restricted lung development, positioning difficulties, difficult venous access and concerns about increased risk for malignant hyperthermia. 75% of arthrogryposis patients do not have a difficult airway. For those with a history of airway problems or those meeting criteria for a difficult airway, careful advanced planning helps to assure safe and successful surgery. We describe several specialized techniques for endotracheal intubation of children with arthrogryposis.ConclusionsChildren and young adults with arthrogryposis are a diverse group. Many pose unique challenges for airway and surgical management. Review of individual anesthesia records and careful advanced planning by a coordinated, experienced airway team can lead to best outcomes from arthrogryposis surgery.

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Section: Management Of the Patient With Arthrogryposismentioning

confidence: 99%

Difficult airway management in children and young adults with arthrogryposis

Isaacson¹,

Drum

2018

World j. otorhinolaryngol.-head neck surg.

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Arthrogryposis multiplex congenita: classification, diagnosis, perioperative care, and anesthesia

2017

Front. Med.

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Arthrogryposis multiplex congenita (AMC) is a rare disorder characterized by non-progressive, multiple contractures. In addition to affected extremities, patients may also present microstomia, decreased temporomandibular joint mobility. Although the etiology of AMC is unclear, any factor that decreases fetal movement is responsible for AMC. Thus, accurate diagnosis and classification are crucial to the appropriate treatment of AMC. The development of ultrasound technology has enabled prenatal diagnosis. Very early treatment is favorable, and multidisciplinary treatment is necessary to improve the function of AMC patients. Most patients require surgery to release contracture and reconstruct joints. However, perioperative care is challenging, and difficult airway is the first concern of anesthesiologists. Postoperative pulmonary complications are common and regional anesthesia is recommended for postoperative analgesia. This review on AMC is intended for anesthesiologists. Thus, we discuss the treatment and perioperative management of patients undergoing surgery, as well as the diagnosis and classification of AMC.

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