Marble bone disease peri-operative challenges and use of POCUS: A case report.

Osteopetrosis, also known as Marble Bone Disease or Albers-Schonberg disease, presents a significant challenge for the anaesthesiologist due to its systemic involvement, anticipated difficult airway, and associated spine deformities. In a recent case, a 17-year-old male with an Autosomal recessive (AR) intermediate form of osteopetrosis was admitted to our centre with a femur fracture on the right side and an old implant in situ, under the Department of Orthopaedics. During pre-anaesthetic evaluation, it was discovered that the patient had an anticipated difficult airway. Radiological examination revealed classical signs such as "sandwich vertebrae" and "bone-in-bone appearance." The sub-arachnoid block was achieved using ultrasound guidance to determine the interspinous space L3-L4. In conclusion, patients with osteopetrosis pose a significant clinical challenge for the anaesthesiologist due to anticipated difficult airway and neuraxial block, along with systemic involvement. Proper management and careful consideration of the patient's unique situation are crucial for successful peri-operative outcomes.