Low Dose Spinal Anaesthesia for a Pediatric Patient with Takayasu's Artheritis Undergoing Orthopaedic Surgery: a case Report

Low Dose Spinal Anaesthesia for a Pediatric Patient with Takayasu's Artheritis Undergoing Orthopaedic Surgery: a case Report

Takayasu's arteritis (TAK) is an arteritis, often granulomatous, predominantly affecting the aorta, its major branches and the pulmonary arteries. Onset usually occurs before the age of 50 years usually second or third decade. TAK is one of the more common etiologies of renovascular hypertension in pediatric age group. Anaesthesia in patients with TAK is complicated with severe uncontrolled hypertension leading to end organ dysfunction, stenosis of major blood vessels affecting regional circulation, and difficulties in monitoring blood pressure. Although spinal anaesthesia is widely using in pediatric age group, we have not seen any report concerning spinal anaesthesia for pediatric patient with TAK. We present a case of successful low dose spinal anaesthesia management of a pediatric patient with TAK, who underwent core decompression operation by orthopedia clinic.

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  • Brunner J, Feldman BM, Tyrrell PN, Kuemmerle-Deschner JB, Zimmerhackl LB, Gassner I, Benseler SM. Takayasu arteritis in children and adolescents. Rheumatology (Oxford). 2010;49(10):1806-14.
  • Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol. 2002;55(7):481-6.
  • Sharma BK, Sagar S, Singh AP, Suri S. Takayasu arteritis in India. Heart Vessels Suppl. 1992;7:37-43.
  • Campos LM, Castellanos AL, Afiune JY, Kiss MH, Silva CA. Takayasu's arteritis with aortic aneurysm associated with Sweet's syndrome in childhood. Ann Rheum Dis. 2005;64(1):168-9.
  • Dutta B, Pandey R, Darlong V, Garg R. Low-dose spinal anaesthesia for a parturient with Takayasu's arteritis undergoing emergency caesarean section. Singapore Med J. 2010;51(6):e111-3.
  • Al Abrawi S, Fouillet-Desjonqueres M, David L, Barral X, Cochat P, Cimaz R. Takayasu arteritis in children. Pediatr Rheumatol Online J. 2008;6:17.
  • Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol. 2002;55(7):481-6.
  • Kathirvel S, Chavan S, Arya VK, Rehman I, Babu V, Malhotra N, Bhukal I, Chari P. Anesthetic management of patients with Takayasu's arteritis: a case series and review. Anesth Analg. 2001;93(1):60-5.
  • Jain S, Sharma N, Singh S, Bali HK, Kumar L, Sharma BK. Takayasu arteritis in children and young indians. Int J Cardiol. 2000;75 Suppl 1:S153-7.
  • Ozen S, Bakkaloglu A, Dusunsel R, Soylemezoglu O, Ozaltin F, Poyrazoglu H, Kasapcopur O, Ozkaya O, Yalcinkaya F, Balat A, Kural N, Donmez O, Alpay H, Anarat A, Mir S, Gur-Guven A, Sonmez F, Gok F; Turkish Pediatric Vasculitis Study Group. Childhood vasculitides in Turkey: a nationwide survey. Clin Rheumatol. 2007;26(2):196- 200.
  • Rowney DA, Doyle E. Epidural and subarachnoid blockade in children. Anaesthesia. 1998;53(10):980-1001.
  • Ubale P, Hemantkumar I. Spinal Anaesthesia for Caesarean Section in a Patient with Takayasu's Arteritis. Bombay Hospital Journal. 2012;54(1):165-7.