Is management of anesthesia in achondroplastic dwarfs really a challenge?

Abstract

Study Objective: To review our eight-year anesthetic experience with achondroplastic patients. Design: Retrospective study. Setting: University hospital. Patients: 15 achondroplastic patients who underwent 53 surgical procedures of orthopedic surgery between 1987 and 1994. Interventions: Anesthetic technique, drugs, number of incidents, and complications in the intraoperative and postoperative period were recorded. Measurements and Main Results: Adequate premedication before the transfer to the operating room was very useful to reduce anxiety and increase cooperation. Inhalation induction was well tolerated and allowed easy peripheral venous cannulation. Only one patient presented difficulties during intubation (on two occasions). In the other patients, we found small difficulties only during ventilation with a face mask, which was easily corrected by modifying the position of the patient and/or inserting an oropharyngeal airway. No adverse effect was identified for any particular anesthetic drug or technique used. Conclusions: Although the characteristic deformities of achondroplastic patients can impede the management of anesthesia, in our study we found no special difficulties. Airway complications did not occur. Thus, no specific optimal anesthetic regimen can be recommended.