Ambulatory general anesthetic experience in a child with Lesch Nyhan syndrome: a case report and literature review

Abstract

Background Lesch-Nyhan syndrome (LNS) is a rare congenital disorder, characterized by self-aggression, self-mutilation, choreoathetosis, and intellectual abnormalities. Ambulatory general anesthesia in LNS children presents a range of challenges. We report a child with LNS who received dental treatment in our ambulatory dental center. Case presentation A 6-year-old boy with LNS was scheduled to undergo treatment for multiple dental caries under ambulatory general anesthesia. To ensure a smooth process, we implemented specific measures for difficult airway management, prevented nausea, vomiting, and pulmonary aspiration, and balanced the use of anesthetic drugs. Post-treatment, the serum uric acid, serum creatinine, and blood urea nitrogen levels remained normal. The entire anesthesia process was complication-free and the child was discharged on the same day. Additionally, we conducted a review and analysis of relevant literature from PubMed and Google Scholar to summarize the anesthetic management experiences in such cases. Conclusion This report details the first successful ambulatory dental general anesthesia for a child with LNS. The management of ambulatory anesthesia for LNS cases is challenging. Despite achieving a positive recovery through comprehensive perioperative management, individualized anesthetic selection and the long-term recovery of the child demand further exploration and research to provide more effective guidance for future clinical practice.