Karla EK Wyatt1*, Sara Anvari2, Renata S Maricevich3 and Sandi K Lam4
1Department of Anesthesiology, Baylor College of Medicine/Texas Children’s Hospital, USA
2Department of Immunology, Allergy and Rheumatology, Baylor College of Medicine/Texas Children’s Hospital, USA
3Department of Plastic Surgery, Baylor College of Medicine/Texas Children’s Hospital, USA
4Department of Neurosurgery, Baylor College of Medicine/Texas Children’s Hospital, USA
Non-syndromic infants with sagittal craniosynostosis are suitable candidates for endoscopic strip craniectomy when diagnosed at a young age. When compared with open cranial vault remodeling, endoscopic strip craniectomy is typically associated with a shorter length of stay and decreased morbidity and mortality. At our institution, the anesthetic management includes an opioid and inhalation-based technique for both endoscopic and open cranial vault remodeling procedures. We present a case in which a 9-month-old underwent an opioid-free and paralytic-free anesthetic for open cranial vault remodeling. This approach was following anaphylaxis after induction for aborted endoscopic strip craniectomy at 8-weeks of age; diagnosis was made with suggestive skin prick and intra dermal testing.
Anaphylaxis; Craniosynostosis; Craniofacial surgery; Pediatric anesthesia; Endoscopic craniectomy
Wyatt KEK, Anvari S, Maricevich RS, Lam SK. An Opioid and Paralytic Free Approach to Craniosynostosis Surgery in the Anaphylactic Patient: A Case Report. Ann Clin Anesth Res. 2019; 3(1): 1020.