Case Report
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World J Anesthesiol. Jul 27, 2014; 3(2): 189-190
Published online Jul 27, 2014. doi: 10.5313/wja.v3.i2.189
Anesthesia for ambulatory surgery in a child with hyposensitivity to pain
Claude Abdallah
Claude Abdallah, Division of Anesthesiology, Children’s National Medical Center, The George Washington University Medical Center, Washington, DC 20010-2970, United States
Author contributions: Abdallah C cited above had complete contribution to conception, writing, and critically revising the intellectual content and approval of the published version of this report.
Correspondence to: Claude Abdallah, MD, MS, Division of Anesthesiology, Children’s National Medical Center, The George Washington University Medical Center, 111 Michigan Avenue, N.W., Washington, DC 20010-2970, United States. cabdalla@cnmc.org
Telephone: +1-202-4762025 Fax: +1-202-4765999
Received: February 22, 2014
Revised: April 19, 2014
Accepted: May 16, 2014
Published online: July 27, 2014
Processing time: 179 Days and 7.5 Hours
Abstract

Congenital hyposensitivity to pain is a condition with predisposition to injury. In these patients, knowledge regarding anesthetic requirements and complications derives from individual case reports, or small case series. Different categories have been described. In patients with hyposensitivity to pain, preventing and treating anxiety as well as insuring immobilization, avoidance of triggering of autonomic reflexes, and sedation are integral aspects for a safe and adequate anesthetic management.

Keywords: General anesthesia; Child; Pain; Hyposensitivity; Surgery

Core tip: Congenital hyposensitivity to pain is a condition with predisposition to injury. In patients with congenital hyposensitivity to pain/Hereditary sensory and autonomic neuropathy (HSAN), knowledge regarding anesthetic requirements and complications derives from individual case reports, or small case series. Different categories of HSAN have been described. Complications in the immediate perioperative period have been described such as mild hypothermia and cardiovascular events, mostly bradycardia and hypotension. The majority of patients with hyposensitivity to pain reported in the literature have received standard anesthesia for surgery. Immobilization, prevention of autonomic reflexes, anxiolysis, and sedation are equally important aspects of the anesthetic management in patients with hyposensitivity to pain.