SUCCESSFUL ANAESTHETIC MANAGEMENT OF AN INFANT WITH CUSHING’S SYNDROME – A RARE CASE REPORT
SUDESHNA BHAR (KUNDU) *
Department of Anaesthesiology, Calcutta National Medical College, 32, Gorachand Road, Kolkata- 700014, West Bengal, India
ANISHA DE
Department of Anaesthesiology, Malda Medical College and Hospital, P.O. Malda, District Malda, West Bengal, India
CHIRANJIB BHATTACHARYYA
Department of Anaesthesiology, Institute of Post Graduate Medical Education and Research, 244, Acharya Jagadish Chandra Bose Road, Kolkata-700020, West Bengal, India
DEBASISH BHAR
Department of Anaesthesiology, Midnapore Medical College and Hospital, Vidyasagar Road, Paschim Medinipur- 721101, West Bengal, India
*Author to whom correspondence should be addressed.
Abstract
Aims: There is no reported case of successful anaesthetic management of an infant with Cushing’s syndrome posted for adrenalectomy. Here, we share our experience in successfully managing such a patient.
Presentation of Case: A 4 month old infant having Cushing’s syndrome was admitted in the hospital with respiratory tract infection and diarrhoea. After proper optimisation, she was posted for left adrenalectomy. Careful anaesthetic induction, endotracheal intubation, close intraoperative monitoring, strict aseptic precautions and postoperative steroid supplementation were followed.
Discussion: Obesity, cardiovascular instability, electrolyte disturbances, glucose intolerance and immunosuppression make the anaesthetic management challenging.
Conclusion: Adequate preoperative optimisation, skilled intraoperative anaesthetic management and careful postoperative care can result in a good outcome.
Keywords: Cushing’s syndrome, infant, adrenalectomy, glucocorticoids