Key result
Spinal anesthesia succeeds during emergency rectal prolapse reduction in osteogenesis imperfecta type IV.
Case Report (n=1)
Spinal anesthesia can be a viable and acceptable alternative to general anesthesia for emergency surgery in patients with osteogenesis imperfecta when performed by expert anesthesiologists.
Spinal anesthesia may be feasible in OI type IV emergency surgery; leaves open safety, efficacy, and generalizability pending larger studies.
Introduction: The choice of anesthetic technique in patients with osteogenesis imperfecta (OI) can be a challenge for anesthesiologists and must be adjusted based on specific circumstances and abnormalities. We report our anesthetic technique in an OI patient to emphasize this point, and to frame a discussion of this subject. According to the accessible data, we report one of the rare OI patients who have undergone spinal anesthesia for emergency surgery. Case Presentation: The patient was a 21-year-old female with OI type IV, who was admitted due to severe anal pain. The surgeon decided to perform an emergency reduction of a prolapsed rectum, with late permanent fixation. Considering the circumstances, we decided to perform spinal anesthesia for the operation, which lasted for 30 minutes. The patient underwent rectal prolapse reduction via rectosigmoidoscopy, of up to 25 cm of rectum. She was transferred to the post-anesthesia care unit after her vital signs were stabilized. After gaining lower extremity strength, she was transferred to the surgery ward. The next day, she was discharged from the hospital. Conclusions: Although most authors believe that general anesthesia following fiberoptic intubation is the preferred method for OI patients, it is likely that spinal anesthesia is acceptable in such patients. Although it is technically difficult, the procedure can be performed by expert anesthesiologists.
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Mirkheshti et al. (2016) conducted a case report in Osteogenesis imperfecta type IV (n=1). Spinal anesthesia was evaluated on Successful completion of surgery and discharge. Spinal anesthesia was successfully performed in a 21-year-old woman with osteogenesis imperfecta type IV undergoing an emergency reduction of a prolapsed rectum.
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