Case Report

Anesthetic Management of Achondroplastic Dwarf with Difficult Airway for Cadaveric Renal Transplantation: A Case Report


Achondroplasia is a congenital autosomal dominant disease which has fibroblast growth factor receptor -3 mutation (FGFR-3). Anesthetic management of achondroplastic patients warrants special anatomical and physiological considerations because of important variations in the airway as well as the spine in regional techniques. In our case, 37-years-old male dwarf with achondroplasia has end stage renal disease (ESRD) and received cadaveric renal transplantation (RT). Preoperative assessment revealed the Mallampati score IV airway with a cervical instability, thoracolumbar kyphoscoliosis and spinal deformities. We aim to highlight anesthetic management of achondroplastic dwarf with difficult airway during operation.

[1]Orioli IM, Castilla EE, Barbosa-Neto JG. The birth prevalence rates for the skeletal dysplasias. Journal of medical genetics. 1986; 23(4):328-32.
[2]Berkowitz ID, Raja SN, Bender KS, Kopits SE. Dwarfs: pathophysiology and anesthetic implications. Anesthesiology. 1990; 73(4):739-59.
[3]Carson BS, Groves M, Yassari R. Neurologicproblems of the spine in achondroplasia. Schmidek and Sweet’s Operative Neurosurgical Techniques. Quinones-Hinojosa A (ed): Elsevier, Amsterdam, Netherlands; 2012.1:2091-9.
[4]Gorji R, Nastasi R, Stuart S, Tallarico R, Li F. Anaesthesia and neuromonitoring for correction of thoracolumbar deformity in an achondroplastic dwarf. Int J Anesthesiol. 2010; 29:1.
[5]Dubiel L, Scott GA, Agaram R, McGrady E, Duncan A, Litchfield KN. Achondroplasia: anaesthetic challenges for caesarean section. Int J Obstet Anesth. 2014; 23(3): 274-278.
[6]O'Connell NE, Ferraro MC, Gibson W, Rice ASC, Vase L, Coyle D, et al. Implanted spinal neuromodulation interventions for chronic pain in adults. Cochrane Database Syst Rev. 2021; 12 (12): CD013756.
[7]Nisa N, Khanna P, Jain D. Anaesthetic Management of an Achondroplastic Dwarf with Difficult Airway and Spine for Total Hip Replacement: A Case Report. Gen Med. 2016; 4: 227.
[8]Kaushal A, Haldar R, Ambesh P. Anesthesia for an achondroplastic individual with coexisting atlantoaxial dislocation. Anesth Essays Res. 2015; 9:443-446.
[9]Shirley ED, Ain MC. Achondroplasia in Brenner’s Encyclopedia of Genetics (Second Edition); 2013. p. 4‑6.
IssueVol 8 No Supplement (2022): Autumn QRcode
SectionCase Report(s)
Achondroplasia Preoperative assessment Difficult airway Anesthesia management Renal transplantation

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Gökdemir B, Çekmen N, Zülfügarlı N, Torgay A. Anesthetic Management of Achondroplastic Dwarf with Difficult Airway for Cadaveric Renal Transplantation: A Case Report. Arch Anesth & Crit Care. 2022;8(Supplement):416-419.