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Anesthetic Management for Ehlers-Danlos Syndrome, Hypermobility Type Complicated by Local Anesthetic Allergy: A Case Report
Patient: Female, 22 Final Diagnosis: Ehlers-Danlos syndrome • hypermobility type Symptoms: Pregnancy Medication: — Clinical Procedure: Cesarean section Specialty: Anesthesiology OBJECTIVE: Unusual clinical course BACKGROUND: Ehlers-Danlos syndrome, hypermobility type is characterized by increased ex...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335977/ https://www.ncbi.nlm.nih.gov/pubmed/30626862 http://dx.doi.org/10.12659/AJCR.912799 |
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author | Cesare, Alexandra E. Rafer, Lorenzo C. Myler, Conrad S. Brennan, Kristin B. |
author_facet | Cesare, Alexandra E. Rafer, Lorenzo C. Myler, Conrad S. Brennan, Kristin B. |
author_sort | Cesare, Alexandra E. |
collection | PubMed |
description | Patient: Female, 22 Final Diagnosis: Ehlers-Danlos syndrome • hypermobility type Symptoms: Pregnancy Medication: — Clinical Procedure: Cesarean section Specialty: Anesthesiology OBJECTIVE: Unusual clinical course BACKGROUND: Ehlers-Danlos syndrome, hypermobility type is characterized by increased extensibility, permeability, and fragility of the affected cartilaginous tissues, including the trachea, larynx, and skin. Anesthetic considerations for patients with this syndrome include intubation difficulties secondary to the collapse of fibro-elastic tissues in the trachea and a reported resistance to local anesthetics. CASE REPORT: Our patient was a 22-year-old G4P0030 woman with a history of morbid obesity, seizures, Barrett’s esophagus, hypermobility being evaluated for Ehlers-Danlos syndrome, and anaphylaxis to an unknown local anesthetic who was scheduled for cesarean delivery. She refused allergy testing. After rapid-sequence induction of general anesthesia, video laryngoscopy facilitated endotracheal intubation. Delivery and recovery were uneventful for the mother and child. CONCLUSIONS: No guidelines for neuraxial or general anesthesia exist for patients with Ehlers-Danlos syndrome, hypermobility type. Increased rates of cervical spine instability and local anesthetic resistance have been reported in this population and should be considered when developing the anesthetic plan. |
format | Online Article Text |
id | pubmed-6335977 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-63359772019-01-29 Anesthetic Management for Ehlers-Danlos Syndrome, Hypermobility Type Complicated by Local Anesthetic Allergy: A Case Report Cesare, Alexandra E. Rafer, Lorenzo C. Myler, Conrad S. Brennan, Kristin B. Am J Case Rep Articles Patient: Female, 22 Final Diagnosis: Ehlers-Danlos syndrome • hypermobility type Symptoms: Pregnancy Medication: — Clinical Procedure: Cesarean section Specialty: Anesthesiology OBJECTIVE: Unusual clinical course BACKGROUND: Ehlers-Danlos syndrome, hypermobility type is characterized by increased extensibility, permeability, and fragility of the affected cartilaginous tissues, including the trachea, larynx, and skin. Anesthetic considerations for patients with this syndrome include intubation difficulties secondary to the collapse of fibro-elastic tissues in the trachea and a reported resistance to local anesthetics. CASE REPORT: Our patient was a 22-year-old G4P0030 woman with a history of morbid obesity, seizures, Barrett’s esophagus, hypermobility being evaluated for Ehlers-Danlos syndrome, and anaphylaxis to an unknown local anesthetic who was scheduled for cesarean delivery. She refused allergy testing. After rapid-sequence induction of general anesthesia, video laryngoscopy facilitated endotracheal intubation. Delivery and recovery were uneventful for the mother and child. CONCLUSIONS: No guidelines for neuraxial or general anesthesia exist for patients with Ehlers-Danlos syndrome, hypermobility type. Increased rates of cervical spine instability and local anesthetic resistance have been reported in this population and should be considered when developing the anesthetic plan. International Scientific Literature, Inc. 2019-01-10 /pmc/articles/PMC6335977/ /pubmed/30626862 http://dx.doi.org/10.12659/AJCR.912799 Text en © Am J Case Rep, 2019 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Articles Cesare, Alexandra E. Rafer, Lorenzo C. Myler, Conrad S. Brennan, Kristin B. Anesthetic Management for Ehlers-Danlos Syndrome, Hypermobility Type Complicated by Local Anesthetic Allergy: A Case Report |
title | Anesthetic Management for Ehlers-Danlos Syndrome, Hypermobility Type Complicated by Local Anesthetic Allergy: A Case Report |
title_full | Anesthetic Management for Ehlers-Danlos Syndrome, Hypermobility Type Complicated by Local Anesthetic Allergy: A Case Report |
title_fullStr | Anesthetic Management for Ehlers-Danlos Syndrome, Hypermobility Type Complicated by Local Anesthetic Allergy: A Case Report |
title_full_unstemmed | Anesthetic Management for Ehlers-Danlos Syndrome, Hypermobility Type Complicated by Local Anesthetic Allergy: A Case Report |
title_short | Anesthetic Management for Ehlers-Danlos Syndrome, Hypermobility Type Complicated by Local Anesthetic Allergy: A Case Report |
title_sort | anesthetic management for ehlers-danlos syndrome, hypermobility type complicated by local anesthetic allergy: a case report |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335977/ https://www.ncbi.nlm.nih.gov/pubmed/30626862 http://dx.doi.org/10.12659/AJCR.912799 |
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