Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942004000500007
Brazilian Journal of Anesthesiology
Clinical Information

Anestesia venosa total em paciente portador de Osteogênesis imperfecta: relato de caso

Total intravenous anesthesia in Osteogenesis imperfecta patient: case report

José Francisco Nunes Pereira das Neves; Roberto Silva Sant'Anna; João Rosa de Almeida; Rodrigo Machado Saldanha; Marcos Gonçalves Magalhães

Downloads: 0
Views: 1089

Resumo

JUSTIFICATIVA E OBJETIVOS: A Osteogênesis Imperfecta é uma doença genética rara do tecido conjuntivo, com prevalência de 1/10000, que primariamente envolve a ossificação endocondral, resultando em ossos frágeis, múltiplas fraturas e deformidades esqueléticas. O objetivo desse artigo foi relatar um caso de paciente portador de Osteogenesis Imperfecta, submetido à anestesia venosa total para tratamento cirúrgico de fratura de fêmur. RELATO DO CASO: Paciente do sexo masculino, 15 anos, 41 kg, 140 cm, com história de Osteogênesis Imperfecta e cardiopatia, programado para tratamento cirúrgico de fratura do fêmur. Na sala de operação foi monitorizado com ECG, FC, PANI e SpO2 e submetido à anestesia geral venosa total com propofol, alfentanil e cisatracúrio. Após IOT, foi acrescentada monitorização da P ET CO2 e da temperatura esofágica. No período intra-operatório e na sala de recuperação pós-anestésica não apresentou complicações. Teve alta hospitalar no 5º dia de pós-operatório. CONCLUSÕES: O presente relato mostrou boa evolução intra e pós-operatória de paciente com Osteogênesis Imperfecta submetido à anestesia geral venosa total. A complexidade da doença mostrou a necessidade de avaliação e monitorização adequada pelo anestesiologista.

Palavras-chave

ANESTESIA, ANESTESIA, DOENÇAS

Abstract

BACKGROUND AND OBJECTIVES: Osteogenesis Imperfecta is an uncommon genetic connective tissue disease with prevalence of 1/10000, primarily involving endochondral ossification, resulting in brittle bones, multiple fractures and skeletal deformities. This article aimed at reporting a case of Osteogenesis Imperfecta patient submitted to total intravenous anesthesia for fractured femur surgical repair. CASE REPORT: Male patient, 15 years old, 41 kg, 140 cm, with history of Osteogenesis Imperfecta and cardiopathy, scheduled for fractured femur surgical repair. In the operating room patient was monitored with ECG, HR, NIBP and SpO2 and was submitted to total intravenous anesthesia with propofol, alfentanil and cisatracurium. Monitoring of P ET CO2 and esophageal temperature was introduced after TI. There have been no complications both in the intraoperative period and in the post-anesthetic care unit. Patient was discharged 5 days later. CONCLUSIONS: This report has shown satisfactory intra and postoperative evolution of Osteogenesis Imperfecta patient submitted to total intravenous general anesthesia. Disease complexity has shown the need for anesthesiologist’s adequate evaluation and monitoring.

Keywords

ANESTHESIA, ANESTHESIA, DISEASES

References

Porsborg P, Astrup G, Bendixen D. Osteogenesis imperfecta and malignant hyperthermia. Is there a relationship?. Anaesthesia. 1996;51:862-865.

Vogel T, Ratner EF, ThomasJr RC. Pregnancy complicated by severe osteogenesis imperfecta: a report of two cases. Anesth Analg. 2002;94:1315-1317.

Keegan MT, Whatcott BD, Harrison BA. Osteogenesis imperfecta, perioperative bleeding, and desmopressin. Anesthesiology. 2002;97:1011-1013.

Edge G, Okafor B, Fennelly ME. An unusual manifestation of bleeding diathesis in a patient with osteogenesis imperfecta. Eur J Anaesthesiol. 1997;14:215-219.

Karabiyik L, Parpucu M, Kurtipek O. Total intravenous anaesthesia and the use of an intubating laryngeal mask in a patient with osteogenesis imperfecta. Acta Anaesthesiol Scand. 2002;46:618-619.

Assis MC, Plotkin H, Glorieux FH. "Osteogenesis Imperfecta": novos conceitos. Rev Bras Ortop. 2002;37:323-327.

Zeitlin L, Rauch F, Plotkin H. Height and weight development during four years of therapy with cyclical intravenous pamidronate in children and adolescents with osteogenesis imperfecta types I, III and IV. Pediatrics. 2003;111:1030-1036.

5dd6e47f0e88255f3a13f286 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections