Anesthetic management with subcostal transversus abdominis plane block in recessive dystrophic epidermolysis bullosa for peritoneal dialysis catheter replacement: a case report

BACKGROUND: Recessive dystrophic epidermolysis bullosa (RDEB) is a rare, hereditary mucocutaneous disorder that can involve renal insufficiency. If a vascular access for hemodialysis is unavailable, peritoneal dialysis can be utilized. This report describes an anesthetic management with ultrasound-guided transversus abdominis plane block (TAPB) in a patient with RDEB for peritoneal dialysis catheter replacement. CASE PRESENTATION: A 49-year-old woman with RDEB needed to undergo peritoneal dialysis catheter replacement. As general, neuraxial and local infiltration anesthesia can lead to serious complications; we planned anesthetic management with subcostal TAPB as the primary analgesia modality. In the operating theater, surgery was initiated after performing left-sided subcostal TAPB. The patient complained of moderate pain at some points during surgery, and the pain was controlled with intravenous or local anesthetics without serious complications. CONCLUSIONS: In summary, subcostal TAPB could be a useful option for peritoneal dialysis catheter surgery in patients with RDEB.