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Question :

Posted On : 08 Jul 2006

A 12 years old child with otism, scoliosis of thoracic spine of 15 degrees, with carotinemia, lipid disorders and muscle weakness presented for orchidopexy in day care unit under general anesthesia. What are the precautions and is it wise to do in main theatre with or without admission postoperatively? Thanks

Expert Answer :

No expert answer available.

Answer Discussion :

pediatriconcall

Here are a few pointers which the anesthesiologist should bear in mind in such a case:

Autism:
Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills.
Autism tends to occur more frequently than expected among individuals who have certain medical conditions, including Fragile X syndrome, tuberous sclerosis, congenital rubella syndrome, and untreated phenylketonuria {PKU}

Carotenemia: This condition most commonly occurs in children with liver disease, hypothyroidism, or diabetes mellitus. Carotenemia may be particularly evident when the stratum corneum is thickened or when the subcutaneous fat is strongly represented.

This child also has an lipid disorder with muscle weakenss , so he could have lipoprotein disorders and some form of ataxia..

Anesthesia considerations would be

1. difficult intubation due to the deposition of fat.. rule of a difficult intubation case or keep ready a difficult intubation cart.

2. Malignant hyperthermia, avoid using agents which predispose the patient to malignant hyperthermia like halothane..

3. Might have deranged liver profile, Keep in mind to use the agents which have first pass metbolism.

4. Might have associated hypothroidism, dosage of drugs shud be borne in mind.

The procedure can be done in day care just extra precations should be taken for administeration of drugs as well as halogenated flouro carbons.

18 years ago

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