Dexmedetomidine as part of a balanced anesthesia and the use of the proseal LMA in a patient with osteogenesis imperfecta for abdominal hysterectomy: a case report

ABSTRACT

Osteogenesis imperfecta is an inherited disorder of collagen with skeletal and extraskeletal manifestations that affect airway and anesthetic management of patients with the disease. This paper aimed to report a case of a patient with osteogenesis imperfecta for abdominal hysterectomy, discuss the anesthetic considerations of patients with the disease, describe balanced anesthesia using high dose dexmedetomidine as a primary agent and, use of ProSeal LMA for airway management. A 44- year old female with osteogenesis imperfecta is scheduled for abdominal hysterectomy for molar pregnancy. Airway management was achieved with a ProSeal LMA, and surgery was conducted using balanced anesthesia with high dose dexmedetomidine, midazolam, fentanyl, atracurium and O2- nitrous oxide. Dexmedetomidine was given at concentrations ranging from 0.7 mcg/kg/hr to 3mcg/kg/hr without untoward adverse effects. No complications were observed intraoperatively and in the immediate postoperative period. Dexmedetomidine is demonstrated to be safe and effective when used as part of a balanced anesthesia for patients with osteogenesis imperfecta. Likewise, the airway can be reliably managed with the use of a ProSeal LMA.