Combined spinal-epidural anesthesia with dexmedetomidine sedation is a feasible regional anesthesia technique for prolonged lower limb surgeries in pediatric patients with Osteogenesis Imperfecta type III.
Suggests feasibility of this regional anesthesia approach for prolonged pediatric lower limb surgeries;.
Osteogenesis imperfecta (OI) is a rare disabling genetic connective tissue disorder. General anesthesia in these patients is associated with increased risks. Regional anesthesia is favored wherever feasible, but there are limited reports of use of a sole regional technique in OI in pediatric patients. Moreover, combined spinal-epidural anesthesia has never been described previously. We are reporting the use of combined spinal-epidural anesthesia for a prolonged surgery (multiple osteotomies) of lower limbs in a 10-year-old wheelchair-bound child with OI type III. Preoperative counseling, ultrasonography guidance, titrated local anesthetic dosage, and dexmedetomidine sedation helped establish optimum surgical conditions.
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Gupta et al. (2017) studied this question.
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