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Anesthetic Challenges in Laparoscopic Surgery for a Child with Juvenile Dermatomyositis

Aruna Parameswari1, S Kanishka1, Keerthana Kalaimani1

  • 1Anesthesiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.

Cureus
|November 11, 2024
PubMed

Insights

This study presents a novel anesthetic approach for juvenile dermatomyositis patients undergoing surgery. Using a laryngeal mask airway and ultrasound-guided block avoided muscle relaxants, improving patient recovery.

Area of Science:

  • Anesthesiology
  • Pediatric Rheumatology

Background:

  • Juvenile dermatomyositis (JDM) patients present anesthetic challenges due to potential sensitivity to neuromuscular blocking agents.
  • Conventional management requires endotracheal intubation and neuromuscular monitoring, risking delayed recovery.

Observation:

  • A 14-year-old female with JDM was scheduled for laparoscopic appendectomy.
  • The case required careful consideration of anesthetic techniques to mitigate disease-related complications.

Findings:

  • A ProSeal™ laryngeal mask airway was employed for airway management.
  • Ultrasound-guided transverse abdominis plane block provided effective analgesia.
  • This combined approach obviated the need for non-depolarizing neuromuscular blockade and monitoring.

Implications:

  • This anesthetic strategy offers a viable alternative for JDM patients, potentially reducing recovery times.
  • It highlights the successful use of supraglottic airway devices and regional anesthesia in this population.
  • Further research could explore broader applications of this technique in pediatric patients with autoimmune myopathies.

Keywords:
case reportjuvenile dermatomyositislaparoscopic surgerysupraglottic airwaytransverse abdominis plane block

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