Spinal anesthesia and postoperative epidural analgesia in a patient with congenital central hypoventilation syndrome -a case report

Korean J Anesthesiol. 2019 Aug;72(4):375-380. doi: 10.4097/kja.d.18.00118. Epub 2018 Nov 14.

Abstract

Background: Congenital central hypoventilation syndrome (CCHS) is a rare disorder characterized by alveolar hypoventilation and autonomic dysregulation. Patients with CCHS have adequate ventilation while awake but exhibit hypoventilation while asleep. More severely affected patients exhibit hypoventilation both when awake and when asleep.

Case: Here, we report a case of successful spinal anesthesia and postoperative epidural analgesia in a patient with CCHS who underwent orthostatic surgery.

Conclusions: In patients with CCHS, anesthesia is used with the goal of minimizing respiratory depression to avoid prolonged mechanical ventilation. Regional anesthesia should be considered where appropriate. Continuous oxygen saturation and end-tidal carbon dioxide monitoring must be available.

Keywords: Autonomic dysregulation; Congenital central hypoventilation syndrome; Hypoxemia; Ondine’s curse; Spinal anesthesia.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Analgesia, Epidural / methods*
  • Anesthesia, Spinal / methods*
  • Carbon Dioxide / metabolism
  • Humans
  • Hypoventilation / congenital*
  • Hypoventilation / physiopathology
  • Male
  • Oxygen / metabolism
  • Postoperative Period
  • Sleep Apnea, Central / physiopathology*

Substances

  • Carbon Dioxide
  • Oxygen

Supplementary concepts

  • Congenital central hypoventilation syndrome