Anaesthesia and partial deletion of chromosome 4

Airway management and quadratus lumborum block for inguinal hernia repair in context of Chromosome 4q deletion: A case report and literature review

“…Dearlove and Sharples present a case report that highlighted a 4QDS patient whose laryngoscopic imaging demonstrated a small larynx with only the posterior arytenoids visualized. 4 While our patient presented with normal laryngeal anatomy as seen in Figure 1C and D, this report demonstrates the utility of video laryngoscopy for intubation in patients with 4QDS. There was potential for difficulty intubating our patient, and the video laryngoscope allowed the anesthesiologist to assess this in real time.…”

“…However, considering the patient's anomalies, there was a concern for the airway requiring a smaller than expected ETT, especially since prior reports of 4QDS have demonstrated such. 4,5 Per the 2022 American Society of Anesthesiologists (ASA), pediatric patients perceived as difficult or potentially difficult can be managed using an airway management algorithm with an emphasis on team-based care. 6 This care includes the use of video laryngoscopy to maximize visualization of a patient's airway and minimize airway intubation attempts.…”

“…This is also in line with the inconsistent reporting of both pain insensitivity and laryngeal narrowing reported in the literature. 2,4,5,9 Our approach, with emphasis on the ASA 2022 Guidelines, maximized patient safety by emphasizing teamwork, communication, and caution. Some limitations of this approach, though, include the resources and time required to successfully carry out this plan.…”

“…3 With specific reference to anesthesia, patients with this syndrome have inconsistently been reported to have laryngeal narrowing, raising the concern for intubation difficulties. 4,5 Due to the rarity of this syndrome and the myriad of clinical presentations, few guidelines are found for the induction of anesthesia in a patient with this syndrome.…”

Airway management and quadratus lumborum block for inguinal hernia repair in context of chromosome 4q deletion: A case report

“…This included the availability of smaller endotracheal tubes and video laryngoscopy equipment. 4,5 Per the 2022 American Society of Anesthesiologists (ASA), pediatric patients perceived as difficult or potentially difficult can be managed using an airway management algorithm with an emphasis on team-based care. 6 This care includes the use of video laryngoscopy to maximize visualization of a patient's airway and minimize airway intubation attempts.…”