Anesthetic management for ehlers-danlos syndrome, hypermobility type complicated by local anesthetic allergy: A case report

Alexandra E. Cesare, Lorenzo C. Rafer, Conrad Myler, Kristin Brennan

Research output: Contribution to journalArticle

Abstract

Objective: Unusual clinical course Background: Ehlers-Danlos syndrome, hypermobility type is characterized by increased extensibility, permeability, and fragility of the affected cartilaginous tissues, including the trachea, larynx, and skin. Anesthetic considerations for patients with this syndrome include intubation difficulties secondary to the collapse of fibro-elastic tissues in the trachea and a reported resistance to local anesthetics. Case Report: Our patient was a 22-year-old G4P0030 woman with a history of morbid obesity, seizures, Barrett’s esophagus, hypermobility being evaluated for Ehlers-Danlos syndrome, and anaphylaxis to an unknown local anesthetic who was scheduled for cesarean delivery. She refused allergy testing. After rapid-sequence induction of general anesthesia, video laryngoscopy facilitated endotracheal intubation. Delivery and recovery were uneventful for the mother and child. Conclusions: No guidelines for neuraxial or general anesthesia exist for patients with Ehlers-Danlos syndrome, hypermobility type. Increased rates of cervical spine instability and local anesthetic resistance have been reported in this population and should be considered when developing the anesthetic plan.

Original languageEnglish (US)
Pages (from-to)39-42
Number of pages4
JournalAmerican Journal of Case Reports
Volume20
DOIs
StatePublished - Jan 1 2019

Fingerprint

Local Anesthetics
Anesthetics
Hypersensitivity
Trachea
General Anesthesia
Ehlers-Danlos Syndrome
Laryngoscopy
Elastic Tissue
Barrett Esophagus
Intratracheal Intubation
Morbid Obesity
Anaphylaxis
Larynx
Intubation
Permeability
Seizures
Spine
Mothers
Guidelines
Skin

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{28b461867d334ac7adfc5b174baccc7e,
title = "Anesthetic management for ehlers-danlos syndrome, hypermobility type complicated by local anesthetic allergy: A case report",
abstract = "Objective: Unusual clinical course Background: Ehlers-Danlos syndrome, hypermobility type is characterized by increased extensibility, permeability, and fragility of the affected cartilaginous tissues, including the trachea, larynx, and skin. Anesthetic considerations for patients with this syndrome include intubation difficulties secondary to the collapse of fibro-elastic tissues in the trachea and a reported resistance to local anesthetics. Case Report: Our patient was a 22-year-old G4P0030 woman with a history of morbid obesity, seizures, Barrett’s esophagus, hypermobility being evaluated for Ehlers-Danlos syndrome, and anaphylaxis to an unknown local anesthetic who was scheduled for cesarean delivery. She refused allergy testing. After rapid-sequence induction of general anesthesia, video laryngoscopy facilitated endotracheal intubation. Delivery and recovery were uneventful for the mother and child. Conclusions: No guidelines for neuraxial or general anesthesia exist for patients with Ehlers-Danlos syndrome, hypermobility type. Increased rates of cervical spine instability and local anesthetic resistance have been reported in this population and should be considered when developing the anesthetic plan.",
author = "Cesare, {Alexandra E.} and Rafer, {Lorenzo C.} and Conrad Myler and Kristin Brennan",
year = "2019",
month = "1",
day = "1",
doi = "10.12659/AJCR.912799",
language = "English (US)",
volume = "20",
pages = "39--42",
journal = "American Journal of Case Reports",
issn = "1941-5923",
publisher = "International Scientific Literature, Inc",

}

Anesthetic management for ehlers-danlos syndrome, hypermobility type complicated by local anesthetic allergy : A case report. / Cesare, Alexandra E.; Rafer, Lorenzo C.; Myler, Conrad; Brennan, Kristin.

In: American Journal of Case Reports, Vol. 20, 01.01.2019, p. 39-42.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Anesthetic management for ehlers-danlos syndrome, hypermobility type complicated by local anesthetic allergy

T2 - A case report

AU - Cesare, Alexandra E.

AU - Rafer, Lorenzo C.

AU - Myler, Conrad

AU - Brennan, Kristin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Unusual clinical course Background: Ehlers-Danlos syndrome, hypermobility type is characterized by increased extensibility, permeability, and fragility of the affected cartilaginous tissues, including the trachea, larynx, and skin. Anesthetic considerations for patients with this syndrome include intubation difficulties secondary to the collapse of fibro-elastic tissues in the trachea and a reported resistance to local anesthetics. Case Report: Our patient was a 22-year-old G4P0030 woman with a history of morbid obesity, seizures, Barrett’s esophagus, hypermobility being evaluated for Ehlers-Danlos syndrome, and anaphylaxis to an unknown local anesthetic who was scheduled for cesarean delivery. She refused allergy testing. After rapid-sequence induction of general anesthesia, video laryngoscopy facilitated endotracheal intubation. Delivery and recovery were uneventful for the mother and child. Conclusions: No guidelines for neuraxial or general anesthesia exist for patients with Ehlers-Danlos syndrome, hypermobility type. Increased rates of cervical spine instability and local anesthetic resistance have been reported in this population and should be considered when developing the anesthetic plan.

AB - Objective: Unusual clinical course Background: Ehlers-Danlos syndrome, hypermobility type is characterized by increased extensibility, permeability, and fragility of the affected cartilaginous tissues, including the trachea, larynx, and skin. Anesthetic considerations for patients with this syndrome include intubation difficulties secondary to the collapse of fibro-elastic tissues in the trachea and a reported resistance to local anesthetics. Case Report: Our patient was a 22-year-old G4P0030 woman with a history of morbid obesity, seizures, Barrett’s esophagus, hypermobility being evaluated for Ehlers-Danlos syndrome, and anaphylaxis to an unknown local anesthetic who was scheduled for cesarean delivery. She refused allergy testing. After rapid-sequence induction of general anesthesia, video laryngoscopy facilitated endotracheal intubation. Delivery and recovery were uneventful for the mother and child. Conclusions: No guidelines for neuraxial or general anesthesia exist for patients with Ehlers-Danlos syndrome, hypermobility type. Increased rates of cervical spine instability and local anesthetic resistance have been reported in this population and should be considered when developing the anesthetic plan.

UR - http://www.scopus.com/inward/record.url?scp=85059797828&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059797828&partnerID=8YFLogxK

U2 - 10.12659/AJCR.912799

DO - 10.12659/AJCR.912799

M3 - Article

C2 - 30626862

AN - SCOPUS:85059797828

VL - 20

SP - 39

EP - 42

JO - American Journal of Case Reports

JF - American Journal of Case Reports

SN - 1941-5923

ER -