Gupta Anju, Kamal Geeta, Gupta Nishkarsh, Aggarwal Anil
From the *Department of Anesthesiology, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, India; †Department of Onco-Anesthesiology and Pain Medicine, DRBRAIRCH, AIIMS, New Delhi, India; and ‡Department of Orthopedics, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, India.
A A Case Rep. 2017 Jul 15;9(2):60-63. doi: 10.1213/XAA.0000000000000527.
Osteogenesis imperfecta (OI) is a rare disabling genetic connective tissue disorder. General anesthesia in these patients is associated with increased risks. Regional anesthesia is favored wherever feasible, but there are limited reports of use of a sole regional technique in OI in pediatric patients. Moreover, combined spinal-epidural anesthesia has never been described previously. We are reporting the use of combined spinal-epidural anesthesia for a prolonged surgery (multiple osteotomies) of lower limbs in a 10-year-old wheelchair-bound child with OI type III. Preoperative counseling, ultrasonography guidance, titrated local anesthetic dosage, and dexmedetomidine sedation helped establish optimum surgical conditions.
成骨不全症（OI）是一种罕见的、导致残疾的遗传性结缔组织疾病。这些患者接受全身麻醉会增加风险。只要可行，区域麻醉是首选，但关于小儿OI患者单独使用区域技术的报道有限。此外，此前从未描述过腰麻-硬膜外联合麻醉。我们报告了在一名10岁、因III型OI而需坐轮椅的儿童下肢延长手术（多次截骨术）中使用腰麻-硬膜外联合麻醉的情况。术前咨询、超声引导、局部麻醉药剂量滴定以及右美托咪定镇静有助于建立最佳手术条件。
