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Anesthesia for Freeman-Sheldon syndrome using a laryngeal mask airway.
Can J Anaesth. 1999 Aug; 46(8):783-7.CJ

Abstract

PURPOSE

To present a case of Freeman-Sheldon syndrome (FSS) with a previously unreported technique of anesthetic management, consisting of a malignant hyperthermia free anesthetic and laryngeal mask airway.

CLINICAL FEATURES

Freeman-Sheldon syndrome (also known as whistling face syndrome, Windmill-Vane-Hand syndrome, cranio-carpo-tarsal dysplasia and distal arthrogryposis type 2) is a rare congenital disorder defined by facial and skeletal abnormalities. The three basic abnormalities are microstomia with pouting lips, camptodactyly with ulnar deviation of the fingers and talipes equinovarus. Patients with FSS frequently present for surgical correction of musculoskeletal or facial abnormalities. There are several anesthetic challenges including difficult airway, intravenous cannulation and regional technique. They may be at increased risk for malignant hyperthermia and postoperative pulmonary complications. We present a case of a two-year-old child with FSS undergoing elective unilateral inguinal hernia repair. A non-triggering anesthetic technique was used, consisting of 2 mg x kg(-1) propofol followed by a continuous infusion, nitrous oxide 50%/oxygen, and 3 microg x kg(-1) fentanyl. Intraoperative and postoperative analgesia was provided by an ilioinguinal nerve block with 10 ml bupivacaine 0.25% with epinephrine 1:200,000. The airway was maintained with a #2 laryngeal mask airway. The anesthetic was uneventful and there were no signs or symptoms of malignant hyperthermia. The patient was discharged home later the same day in good health.

CONCLUSION

The use of a laryngeal mask airway and non-triggering anesthetic technique should be considered as options for anesthetic management in patients with FSS for short procedures that do not require neuromuscular blockade.

Authors+Show Affiliations

Department of Anesthesia, The Hospital for Sick Children, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

10451140

Citation

Cruickshanks, G F., et al. "Anesthesia for Freeman-Sheldon Syndrome Using a Laryngeal Mask Airway." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 46, no. 8, 1999, pp. 783-7.
Cruickshanks GF, Brown S, Chitayat D. Anesthesia for Freeman-Sheldon syndrome using a laryngeal mask airway. Can J Anaesth. 1999;46(8):783-7.
Cruickshanks, G. F., Brown, S., & Chitayat, D. (1999). Anesthesia for Freeman-Sheldon syndrome using a laryngeal mask airway. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 46(8), 783-7.
Cruickshanks GF, Brown S, Chitayat D. Anesthesia for Freeman-Sheldon Syndrome Using a Laryngeal Mask Airway. Can J Anaesth. 1999;46(8):783-7. PubMed PMID: 10451140.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anesthesia for Freeman-Sheldon syndrome using a laryngeal mask airway. AU - Cruickshanks,G F, AU - Brown,S, AU - Chitayat,D, PY - 1999/8/18/pubmed PY - 1999/8/18/medline PY - 1999/8/18/entrez SP - 783 EP - 7 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 46 IS - 8 N2 - PURPOSE: To present a case of Freeman-Sheldon syndrome (FSS) with a previously unreported technique of anesthetic management, consisting of a malignant hyperthermia free anesthetic and laryngeal mask airway. CLINICAL FEATURES: Freeman-Sheldon syndrome (also known as whistling face syndrome, Windmill-Vane-Hand syndrome, cranio-carpo-tarsal dysplasia and distal arthrogryposis type 2) is a rare congenital disorder defined by facial and skeletal abnormalities. The three basic abnormalities are microstomia with pouting lips, camptodactyly with ulnar deviation of the fingers and talipes equinovarus. Patients with FSS frequently present for surgical correction of musculoskeletal or facial abnormalities. There are several anesthetic challenges including difficult airway, intravenous cannulation and regional technique. They may be at increased risk for malignant hyperthermia and postoperative pulmonary complications. We present a case of a two-year-old child with FSS undergoing elective unilateral inguinal hernia repair. A non-triggering anesthetic technique was used, consisting of 2 mg x kg(-1) propofol followed by a continuous infusion, nitrous oxide 50%/oxygen, and 3 microg x kg(-1) fentanyl. Intraoperative and postoperative analgesia was provided by an ilioinguinal nerve block with 10 ml bupivacaine 0.25% with epinephrine 1:200,000. The airway was maintained with a #2 laryngeal mask airway. The anesthetic was uneventful and there were no signs or symptoms of malignant hyperthermia. The patient was discharged home later the same day in good health. CONCLUSION: The use of a laryngeal mask airway and non-triggering anesthetic technique should be considered as options for anesthetic management in patients with FSS for short procedures that do not require neuromuscular blockade. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/10451140/Anesthesia_for_Freeman_Sheldon_syndrome_using_a_laryngeal_mask_airway_ L2 - https://doi.org/10.1007/BF03013916 DB - PRIME DP - Unbound Medicine ER -