Anesthesia in an infant with spinal muscular atrophy type 1 for ventriculoperitoneal shunt placement

Abstract

Introduction Spinal muscular atrophy (SMA) is a rare inherited disease in the pediatric population. The most important risk factor associated with anesthesia is increased sensitivity to opioids and neuromuscular blockers as well as problems with airway management and breathing. We present a case report of an eight-month-old female infant undergoing ventriculoperitoneal shunt placement.

Case outline The infant underwent ventriculoperitoneal shunt placement for hydrocephalus following nusinersen intrathecal injection. The premedication with benzodiazepines is omitted. Except for SMA, the child was considered without comorbidity. The general endotracheal anesthesia was managed with inhalational sevoflurane. The opioid analgesics as well as rocuronium for neuromuscular blockade in a single dose were administered to the child. After the surgery, the child was awake in the operating theater.

Conclusion General endotracheal anesthesia in infants with SMA can be safely performed. Intravenous anesthesia as well as inhalational anesthesia with sevoflurane are acceptable possibilities.

Keywords: spinal muscular atrophy; anesthesia; inhalational; ventriculoperitoneal shunt