Combined spinal epidural anesthesia in achondroplastic dwarf for femur surgery

  • Rochana Girish Bakhshi | drrochana@yahoo.com Department of Anaesthesia, Padmashree Dr D.Y. Patil Medical College & Hospital, Nerul, Navi Mumbai, Maharashtra, India.
  • Sheetal R. Jagtap Department of Anaesthesia, Padmashree Dr D.Y. Patil Medical College & Hospital, Nerul, Navi Mumbai, Maharashtra, India.

Abstract

Achondroplasia is the commonest form of short-limbed dwarfism and occurs in 1:26,000- 40,000 live births. This is an autosomal dominant disorder with abnormal endochondral ossification whereas periosteal and intramembranous ossification are normal. The basic abnormality is a disturbance of cartilage formation mainly at the epiphyseal growth plates and at the base of the skull. The anesthetic management of achondroplastic dwarfs is a challenge to the anesthesiologist. Both regional as well as general anesthesia have their individual risks and consequences. We report a case of an achondroplastic dwarf in whom combined spinal epidural anesthesia was used for fixation of a fractured femur. The patient had undergone previous femur surgery under general anesthesia since he had been informed that spinal anesthesia could be very problematic. There was no technical difficulty encountered during the procedure and an adequate level was achieved with low-dose local anesthetics without any problem. Postoperative pain relief was offered for three consecutive postoperative days using epidural tramadol. We discuss the anesthetic issues and highlight the role of combined spinal epidural anesthesia with low-dose local anesthetics in this patient. This approach also helped in early ambulation and postoperative pain relief.

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Author Biographies

Rochana Girish Bakhshi, Department of Anaesthesia, Padmashree Dr D.Y. Patil Medical College & Hospital, Nerul, Navi Mumbai, Maharashtra

Department of Anaesthesia,
Padmashree Dr D.Y.Patil Medical College &  Hospital, Nerul, Navi Mumbai-400706, Maharashtra, India

Professor

Sheetal R. Jagtap, Department of Anaesthesia, Padmashree Dr D.Y. Patil Medical College & Hospital, Nerul, Navi Mumbai, Maharashtra

 

Professor

Published
2011-11-29
Section
Case Reports
Keywords:
achondroplastic dwarf, spinal, epidural, regional anesthesia.
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How to Cite
Bakhshi, R., & Jagtap, S. (2011). Combined spinal epidural anesthesia in achondroplastic dwarf for femur surgery. Clinics and Practice, 1(4), e120. https://doi.org/10.4081/cp.2011.e120