Background and aims Cystic fibrosis (CF) is the most frequent hereditary disease among caucasians resulting of autosomic recessive mutation of protein CFTR (cystic fibrosis transmembrane conductance regulator) located in chromosome 7. We report a case of acute appendicitis in a CF patient to analyze the advantages of regional anesthesia in the perioperative management of this population.
Methods Case report and review of literature (PubMed).
Results We report a case of acute appendicitis in a 29-year-old male with severe lung affectation for CF requiring 24-hour home oxygen-therapy and night-time non-invasive mechanical ventilation (NIMV). We decided to perform an open surgery under neuraxial block with mild sedation after considering respiratory impact of general anesthesia. The procedure was uneventful with hemodynamic stability, peripheral oxygen saturation (Sp02 2) higher than 98% and patient maintaining spontaneous ventilation. Patient was satisfied and comfortable. After surgery there were no complications, with the patient being transferred from post-anaesthesia care unit (PACU) after 60 minutes and discharged home after 48 hours.
Conclusions Neuraxial anesthesia should be considered when managing these patients in order to avoid the risks of respiratory complications related with general anesthesia in the population with cystic fibrosis.
Given the improving life expectancy of the population with cystic fibrosis, we should expect an increase in the number of patients presenting for surgery with this condition.
Further research is needed given the scarcity of literature regarding this topic.
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