Diastrophic Dwarf with a Difficult Airway and Malignant Hyperthermia for Urgent Cesarean Section

Abstract

The patient is a diastrophic dysplasic dwarf presenting emergently for primary cesarean section for breech presentation. DD (Diastrophic dysplasia) is a disorder of cartilage leading to short stature and scoliosis. The patient had difficult intubations reported in seven previous anesthetics and an episode consistent with malignant hyperthermia. The severe curvature of her spine precluded use of regional anesthesia. She was sedated with midazolam and propofol while maintaining spontaneous ventilation. Multiple fiberopitc intubation attempts failed and a #4 LMA was placed. With the patient breathing spontaneously anesthesia was maintained with propofol and nitrous oxide. She delivered a healthy male and suffered no complications.