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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2013 July;79(7):727-32
Anesthetic management in pediatric patients with epidermolysis bullosa: a single center experience
Van Den Heuvel I. 1, 2, Boschin M. 1, Langer M. 3, Frosch M. 2, Gottschalk A. 1, Ellger B. 1, Hahnenkamp K. 1 ✉
1 Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University hospital Muenster, Germany;
2 Department of General Pediatrics, University Children’s Hospital Muenster, Muenster, Germany;
3 Department of Trauma-, Hand- and Reconstructive Surgery, University hospital Muenster, Germany
Background: Anesthesia in children with dystrophic epidermolysis bullosa (EB) presents a significant challenge as many children have a difficult airway and are at risk for additional blistering. In this retrospective study we compared deep sedation/ analgesia and general anesthesia for safety and efficiency. Procedure, type of anesthesia, airway management, complications, time for induction and awakening, length of stay in recovery room, length of procedure were noted and compared, qualitatively and with statistic tests as appropriate.
Methods: Fourteen children underwent 148 procedures: 79 under general anesthesia, 67 under sedation.
Results: Several complications – including intubation difficulties and the need for change of airway management – were observed in the general anesthesia group, none in the sedated group. Induction time was 36 min vs. 17 min (P<0.001), mean time to recovery 23 min vs. 6 min (P<0.001). Surgical duration did not differ between groups.
Conclusions: In children with dystrophic EB deep sedation/ analgesia can be safely performed and is less time consuming than traditional management.