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.
References
for Infants and Children. 8th ed. Philadelphia: Elsevier
Mosby; 2011.
2. Barash PGC, Bruce F, Stoelting RK. Clinical Anesthesia. 5th
ed. Philadelphia: Lipincott Williams & Wilkins; 2006.
3. Litman RS, Rosenberg H. Malignant hyperthermia:
update on susceptibility testing. JAMA : the Journal of
the American Medical Association. [Research Support,
Non-U.S. Gov’t]. 2005 Jun 15;293(23):2918-24.
4. Malignant Hyperthermia Association of the United States.
2011; Available from: http://www.mhaus.org/. Accessed
June1, 2012
5. Rosenberg H, Davis M, James D, Pollock N, Stowell K.
Malignant hyperthermia. Orphanet journal of rare diseases.
[Review]. 2007;2:21.
6. Guideline Statement for Malignant Hyperthermia in
the Perioperative Environment. Association of Surgical
Technologies [serial on the Internet]. 2005; (October):
Available from: http://www.ast.org/pdf/Standards_of_Practice/
Guideline_Malignant_Hyperthermia.pdf. Accessed January
22, 2012
7. Rosenberg H, Antognini JF, Muldoon S. Testing for malignant
hyperthermia. Anesthesiology. [Research Support,
Non-U.S. Gov’t]. 2002 Jan;96(1):232-7.
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