Opioid-free anesthesia for a child with trisomy 13 with obstructive sleep apnea: a case report

Area of Science:

• Anesthesiology
• Pediatric Medicine
• Genetics

Background:

• Trisomy 13 is associated with central apnea and increased risk of opioid-induced respiratory depression.
• Children with trisomy 13 often have comorbidities that complicate anesthesia management.
• Obstructive sleep apnea is a common comorbidity in children with trisomy 13.

Purpose of the Study:

• To evaluate the safety and efficacy of opioid-free anesthesia in a pediatric patient with trisomy 13.
• To demonstrate successful extubation in the operating room for a patient with trisomy 13 and central apnea.
• To establish a potential anesthetic protocol for children with trisomy 13 and respiratory comorbidities.

Main Methods:

• Opioid-free general anesthesia was administered using sevoflurane and nitrous oxide.
• Acetaminophen was utilized for postoperative analgesia.
• The patient was extubated in the operating room following a stable breathing pattern.

Main Results:

• The patient with trisomy 13 and obstructive sleep apnea was safely extubated in the operating room.
• Opioid-free anesthesia was successfully repeated two years later for a different procedure.
• No opioid-related respiratory complications were observed.

Conclusions:

• Opioid-free anesthesia is a safe and viable option for children with trisomy 13 and associated respiratory comorbidities.
• Non-narcotic analgesics, such as acetaminophen, can provide adequate postoperative pain relief.
• This anesthetic approach minimizes the risk of respiratory depression in this vulnerable patient population.