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IntroductIonOsteochondroma is a benign tumor of the bone affecting long bones.Hereditary multiple osteochondromas is a rare condition characterized by exostosis of growth plates of long bones, ribs, and vertebrae. 1,2Osteochondromas of the spine constitute about 3% of all osteochondromas. 3Anesthesia management can be challenging if the osteochondromas are located in potentially dangerous and delicate locations.We describe the case report of an 18-year-old girl with multiple osteochondromas who underwent excision of an osteochondroma of the spine. case descrIptIonAn 18-year-old female patient weighing 50 kg presented to our hospital with swelling on the right side of the back, left arm and left thigh.On evaluation, she was diagnosed with hereditary multiple exostoses (HME).The swellings were painless with no neurological signs or symptoms.CT scan revealed osteochondroma arising from the T12 vertebra, and the patient was scheduled for excision of the exostosis from the thoracic vertebrae.Figures 1 and2 show chest X-ray exostosis of the spine and humerus.The investigations were unremarkable.The case was classified as American Society of Anesthesiologists I for general anesthesia, and a double-lumen tube with one-lung ventilation was planned for better exposure.Informed consent was obtained.The patient was kept nil by mouth for 6 hours for solids and 2 hours for liquids.An intravenous (IV) cannula was secured with a 20-gauge needle in the left hand.The patient was preoxygenated with 100% oxygen for 3 minutes.Premedication included injection (Inj.)glycopyrrolate 0.2 mg IV and Inj.midazolam 1 mg IV.General anesthesia induction was achieved with Inj.morphine 0.1 mg/kg, Inj.propofol 2 mg/kg IV, and Inj.vecuronium 0.08 mg/kg IV.A 32 French left-sided double-lumen endotracheal tube was inserted, and its position was confirmed by auscultation and fiber-optic bronchoscopy.
Jois et al. (Tue,) studied this question.