Ann Clin Anesth Res | Volume 3, Issue 1 | Case Report | Open Access

An Opioid and Paralytic Free Approach to Craniosynostosis Surgery in the Anaphylactic Patient: A Case Report

Karla EK Wyatt^1*, 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

^*Correspondance to: Karla EK Wyatt 

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Abstract

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.

Keywords:

Anaphylaxis; Craniosynostosis; Craniofacial surgery; Pediatric anesthesia; Endoscopic craniectomy

Citation:

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.