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Lodder-Merla Syndrome, a Multisystemic Disorder: Perioperative Anesthetic Management of an Infant

Elsa Astyrakaki1, Eleanna Garini2, Savva Georgousi2

  • 1'Children's Hospital Aghia Sophia', Department of Anesthesiology, Athens, Greece. astyrakaki@hotmail.com.

Acta Medica Academica
|November 13, 2025
PubMed

Insights

Anesthetic management for infants with Lodder-Merla syndrome presents unique challenges, particularly concerning respiratory and cardiac stability during surgery. Multidisciplinary collaboration is crucial for optimizing care in these complex cases.

Area of Science:

  • Pediatric Anesthesiology
  • Medical Genetics
  • Syndromology

Background:

  • Lodder-Merla syndrome is a rare genetic disorder with multi-organ involvement.
  • Infants with this syndrome often present with complex medical histories, including cardiac devices and neurological issues.

Purpose of the Study:

  • To detail the perioperative anesthetic considerations for an infant diagnosed with Lodder-Merla syndrome.
  • To highlight the anesthetic challenges associated with a rare genetic syndrome and multiple comorbidities.

Main Methods:

  • Case report of a 7-month-old infant with Lodder-Merla syndrome undergoing open gastrostomy and gastrojejunal tube insertion.
  • Focus on maintaining cardiorespiratory stability, seizure control, and aspiration prevention during general anesthesia.

Main Results:

  • Successful anesthetic management was achieved by prioritizing respiratory and cardiac stability.
  • Specific anesthetic strategies included avoiding parasympathomimetic drugs and optimizing ventilation.

Conclusions:

  • Perioperative anesthetic management in Lodder-Merla syndrome requires careful attention to the patient's multi-system involvement.
  • Effective multidisciplinary collaboration and system optimization are essential for favorable outcomes.
Abstract

Keywords:
ChildLodder-MerlaSick Sinus Disease

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