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Canadian Journal of Anesthesia, Vol 33, 484-487, Copyright © 1986 by Canadian Anesthesiologists' Society

Clinical Reports: Dental Anaesthesia For a Child With Complete Amelia

ALAN TALLMEISTER MD1, MARGARET M. SHEEHAN MD, FRCPC1, and DAVID A. PELTON MD, FRCPC1

1 Department of Anaesthesia, The Hospital for Sick Children, Toronto, Ontario

Address correspondence to: Dr. D. A. Pelton, Department of Anaesthesia, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8.

A four year-old boy born without limbs (amelia) presented for dental restorations under general anaesthesia as an outpatient. Following intramuscular atropine administration anaesthesia was induced using halothane, oxygen and nitrous oxide inhaled by mask. Next, intravenous access was secured by external jugular vein catheterization. Because of his small mouth, hypognathic mandible, arched palate and anterior-superiorly located larynx, oral intubation under deep anaesthesia during spontaneous ventilation was difficult. The epiglottis was noted to be inverted on subsequent laryngoscopic inspection after intubation but was reduced mechanically to anatomic position. Despite being unable to accurately monitor the blood pressure the intraoperative period was uneventful. Postoperatively the patient was extubated and was able to return home the same day.

Key Words: ANAESTHESIA: paediatric • CONGENITAL ANOMALIES: amelia






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Copyright © 1986 by the Canadian Anesthesiologists' Society.