Case study: Anaesthetic management of an achondroplastic dwarf undergoing radical nephrectomy

Abstract

A three feet two inch (96 cm) tall achondroplastic patient with urothelial cell carcinoma involving renal pelvis was scheduled for a radical nephrectomy. Radial artery cannulation and central venous access were securedin the pre-induction period. After induction, the airway was secured using a flexible fibreoptic scope. General anaesthesia was maintained with oxygen-nitrous-oxide and continuous propofol infusion. The total duration of anaesthesia was three hours and 50 minutes. To the best of the authors’ knowledge, this is the shortest adult achondroplastic patient ever reported to undergo such major abdominal surgery under general anaesthesia. The anaesthetic implications in patients with achondroplasia are reviewed in this case report.