A patient with achondroplasia may present some challenges for anesthesia management. Krishnan et al identified risk factors that should be considered prior to induction. The authors are from Vellore, India.


Potential Risk Factor


upper airway obstruction (associated with brachycephaly, facial hypoplasia), narrow nasopharyngeal airway

difficult intubation and airway management

central apnea

disordered breathing

small glottis and trachea

require endotracheal tubes that are smaller than expected based on age

stenosis of the foramen magnum and narrowing of the upper cervical spinal canal

hyperextension of the neck should be avoided in order to prevent cervical cord compression

difficult venous access due to laxity of skin and soft tissues and to flexion deformities in the limbs

ensure vascular access in advance of any procedure

severe kyphoscoliosis

small lung volumes with difficult ventilation and hypoxemia

tendency for respiratory complications after surgery (atelectasis, hypoxemia, pneumonia)

careful observation after surgery to make sure that recovery is complete


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