Most patients with achondroplasia will at some time need to undergo surgery requiring anesthesia. Recognition of possible problems in advance can help reduce complications.


Findings that may affect anesthesia:

(1) narrow nasal airway and nasopharynx

(2) restrictive lung disease associated with rib hypoplasia and thoracic lordosis

(3) cor pulmonale secondary to restrictive lung disease

(4) central and obstructive sleep apnea

(5) stenosis at the foramen magnum with constriction of the cervicomedullary junction

(6) thoracolumbar spinal stenosis

(7) hydrocephalus


Problems during anesthesia:

(1) extension of the neck during intubation may compress the cervical spine

(2) if hydrocephalus is present, placing a blanket under the thorax can help in visualizing the glottis during intubation.

(3) restrictive lung disease

(4) narrow nasal passage may make passing a nasal catheter difficult

(5) pain associated with spinal stenosis may affect positioning of the patient

(6) pulmonary edema if cor pulmonale present

(7) obstructive apnea may develop during recovery


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