Anesthesia for a Patient with Osteogenesis Imperfecta, Achondroplastic Dwarfism and History of Malignant Hyperthermia

Abstract

A primary goal for anesthesia providers is to maintain patient

safety. This is an even greater concern when taking care of a

patient with a complicated medical history. This case report,

discusses the care of a 47 year-old female patient who presented

to a tertiary care center for an orthopedic procedure. Her

medical history included osteogenesis imperfecta (OI), achondroplastic

dwarfism and suspicion of malignant hyperthermia (MH).

There were multiple anesthetic implications to ensure safety for

this patient during the perioperative period. OI concerns include

bone fragility and potential for multiple fractures even after

inoffensive trauma. Achondroplastic dwarfism concerns include

abnormalities of the upper airway and difficulty with visualizing

the glottic opening during direct laryngoscopy.1 Malignant

Hyperthermia is a life threatening disorder, which places the

patient at risk for a hypermetabolic reaction if exposed to select

anesthetic agents.