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

  • Jaclyn Harvey, SRNA


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.


1. Davis PJ, Cladis FP & Motoyama EK. Smith’s Anesthesia
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: 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:
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.
How to Cite
HARVEY, SRNA, Jaclyn. Anesthesia for a Patient with Osteogenesis Imperfecta, Achondroplastic Dwarfism and History of Malignant Hyperthermia. Anesthesia eJournal, [S.l.], v. 1, n. 1, jan. 2013. ISSN 2333-2611. Available at: <>. Date accessed: 24 feb. 2020.