Spinal anesthesia in a patient with congenital insensitivity to pain with anhidrosis.
Congenital insensitivity to pain with anhidrosis (CIPA) is a rare, hereditary, autonomic recessive disorder. The inability to perceive pain results from loss of nociceptive afferents, while anhidrosis is caused by loss of innervation to the sweat glands. Insensitivity to pain and mental retardation lead to self-inflicted injuries, corneal lacerations, painless bony fractures, joint deformities with consequent chronic osteomyelitis, and septic arthritis. There are only a few reports on the anesthetic management for patients with CIPA. We describe the anesthetic management of a young woman with CIPA receiving bilateral arthrodesis of the ankle.
Oliveira
Carlos R D
CR
Department of Anesthesiology, Irmandade da Santa Casa de Misericórdia de Santos, CET em Anestesiologia da Santa Casa de Santos, Santos, São Paulo, Brazil. anestesiologia@hotmail.com
dos Santos
Fúlvio A
FA
Nogueira
Celso S
CS
Mainardes
Emerson J
EJ
D000328:Adult; D000775:Anesthesia, Spinal / Q000379:methods*; D005260:Female; D009477:Hereditary Sensory and Autonomic Neuropathies / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D000699:Pain Insensitivity, Congenital / Q000175:diagnosis / Q000628:therapy