Abstract
In patients with osteogenesis imperfecta (OI), general anesthetic management should be carefully implemented in consideration of difficult intubation and the potential risks of cervical or mandibular fracture associated with tracheal intubation, bone fracture during postural changes, and respiratory dysfunction due to thoracic deformity. To prevent temperature elevation, moreover, many reports have recommended anesthetic management using total intravenous anesthesia (TIVA) rather than inhalation anesthetics, which contribute to temperature elevation. In an 8-year-old boy with type II (fatal type) OI (height, 81 cm; body weight, 12.4 kg), we performed general TIVA with remifentanil and propofol, using a laryngeal mask airway for airway management. All possible intra- and postoperative complications were effectively prevented, and the remifentanil requirement was high, as shown by a mean dose of 0.36 μg·kg−1·min−1.
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References
Szmuk P, Ezri T, Soroker D. Total intravenous anaesthesia for patients with osteogenesis imperfecta. Paediatr Anaesth. 1994;4:344.
Hall RMO, Henning RD, Brown TCK, Cole WG. Anaesthesia for children with osteogenesis imperfecta: a review covering 30 years and 266 anaesthetics. Paediatr Anaesth. 1992;2:115–121.
Rodrigo C. Anesthesia for maxillary and mandibular osteotomies in osteogenesis imperfecta. Anesth Prog. 1995;42:17–20.
Muñoz HR, Cortínez LI, Ibacache ME, Altermatt FR. Remifentanil requirements during propofol administration to block the somatic response to skin incision in children and adults. Anesth Analg. 2007;104:77–80.
Karabiyik L, Çapan Z. Osteogenesis imperfecta: different anaesthetic approaches to two paediatric cases. Paediatr Anaesth. 2004;14:524–525.
Roughley PJ, Rauch F, Glorieux FH. Osteogenesis imperfecta clinical and molecular diversity. Eur Cell Mater. 2003;5:41–47.
Peliso A, Cerullo M. Malignant hyperthermia susceptibility in patients with osteogenesis imperfecta. Paediatr Anaesth. 1995;5:398–399.
Karabiyik L, Parpucu M, Kurtipek O. Total intraveneous anaesthesia and the use of an intubating laryngeal mask in a patient with osteogenesis imperfecta. Acta Anaesthesiol Scand. 2002;46:618–619.
Park HJ, Lee JR, Kim CS, Kim SD. Remifentanil halves the EC50 of propofol for successful insertion of the laryngeal mask airway and laryngeal tube in pediatric patients. Anesth Analg. 2007;105:57–61.
Kill C, Leonhardt A, Wulf H. Lactic acidosis after short-term infusion of propofol for anaesthesia in a child with osteogenesis imperfecta. Paediatr Anaesth. 2003;13:823–826.
Brimacombe J, Keller C, Fullekrug B, Agro F. A multicenter study comparing the Proseal and classic laryngeal mask airway in anesthetized, nonparalyzed patients. Anesthesiology. 2002;96:289–295.
Santos ML, Añez C, Fuentes A, Méndez B. Airway management with ProSeal LMA in a patient with osteogenesis imperfecta. Anesth Analg. 2006;103:794.
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Ogawa, S., Okutani, R. & Suehiro, K. Anesthetic management using total intravenous anesthesia with remifentanil in a child with osteogenesis imperfecta. J Anesth 23, 123–125 (2009). https://doi.org/10.1007/s00540-008-0698-z
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DOI: https://doi.org/10.1007/s00540-008-0698-z