Kaur Jasleen, Durga Padmaja, Jonnavithula Nirmala, Ramachandran Gopinath
Department of Anaesthesiology and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.
Indian J Anaesth. 2011 May;55(3):296-8. doi: 10.4103/0019-5049.82691.
Achondroplasia, a common cause of short limbed type of dwarfism is due to quantitative decrease in rate of endochondral ossification. This abnormal bone growth leads to disproportionate body and head structure, thus placing them under high risk for anaesthetic management. There is paucity in literatures, regarding appropriate drug dosage selection in these patients. Use of drugs as per standard dosage recommendations based on body weight or body surface area, may not be adequate in these patients owing to discrepancies in overall body weight and lean body weight, especially during rapid sequence induction. Here, we report a case of failed rapid sequence induction due to abnormal response to administered drugs in an adult achondroplastic dwarf. Standard doses of thiopentone and rocuronium had to be repeated thrice to achieve adequate conditions for intubation.
软骨发育不全是导致短肢型侏儒症的常见原因，是由于软骨内骨化速率的定量减少所致。这种异常的骨骼生长会导致身体和头部结构比例失调，从而使他们在麻醉管理下面临高风险。关于这些患者合适的药物剂量选择，文献中较为匮乏。根据体重或体表面积按照标准剂量建议使用药物，在这些患者中可能并不足够，因为总体重和瘦体重存在差异，尤其是在快速顺序诱导期间。在此，我们报告一例成年软骨发育不全侏儒患者因对所用药物反应异常导致快速顺序诱导失败的病例。硫喷妥钠和罗库溴铵的标准剂量不得不重复三次才能达到足够的插管条件。
