General anesthesia in patients with syndrome of Poland

Area of Science:

• Anesthesiology
• Rare Diseases
• Congenital Disorders

Background:

• Poland Syndrome is a rare congenital condition affecting muscle development, potentially causing thoracic anomalies and increasing risks like malignant hyperthermia during surgery.
• Anesthetic management for patients with Poland Syndrome requires careful consideration due to potential airway complications and susceptibility to specific anesthetic agents.
• Surgical interventions, including breast prosthesis placement, are increasingly common, necessitating tailored anesthetic approaches for rare disease patients.

Observation:

• A patient with Poland Syndrome undergoing breast prosthesis surgery presented unique anesthetic challenges.
• Initial anesthetic approach involved avoiding halogenated agents and utilizing Total Intravenous Anesthesia (TIVA) with propofol.
• Muscle spasms occurred during propofol administration, indicating a potential adverse reaction in this patient.

Findings:

• The use of propofol in this Poland Syndrome patient resulted in unexpected muscle spasms.
• A second anesthetic procedure was required to manage the patient's condition.
• Total Intravenous Anesthesia (TIVA) with midazolam was successfully employed in the subsequent procedure.

Implications:

• This case underscores the importance of individualized anesthetic strategies for rare diseases like Poland Syndrome.
• Anesthesiologists must be prepared for potential adverse reactions to common anesthetic agents in patients with specific congenital conditions.
• Alternative anesthetic agents and techniques, such as TIVA with agents like midazolam, may be crucial for safe surgical management in susceptible patients.