Abstract
Epidermolysis Bullosa (EB) is characterized by the presence of extremely fragile skin and painful blister formations in the skin. We present the anesthetic management of 15-years-old, twin sisters with EB during the syndactyly operation. Premedication was done with 0.5 mg/kg nasal midazolam. Anesthesia induction was performed with sevoflurane without touching the facial masks to the skin. After intravenous 2 mgkg-1 ketamine and 50 μg fentanyl, anesthesia was maintained by intravenous 1 mg/kg/hr ketamine and 0.1 μg/kg/min remifentanil. We injected 2 mg intravenous morfin for postoperative pain control. Ketamine with remifentanil seems to be effective, simple, and safe for airway management and practical way to provide general anesthesia and analgesia of EB.
Highlights
There are more than 20 different described subtypes of epidermolysis bullosa
We used a combination of ketamine-remifentanil in order to minimize intervention to airway control
We present the anesthetic management for twin patients with epidermolysis bullosa caried out during the syndactyly operation. 15-year-old, 24 kg and 25 kg, twin sisters with epidermolysis bullosa underwent operation for syndactyly
Summary
Successful use of ketamin combined with remifentanil in two patients with epidermolysis bullosa. Epidermolizis büllozalı iki hastada remifentanil ile ketaminin birlikte başarılı kullanımı İlker Öngüç Aycan[1], Aysun Ankay Yilbaş[2], Şennur Uzun[3], Özgür Canbay[3], Turgay Öcal[3], Saadet Özgen[3]
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