Management of anesthesia

The primary concerns during anesthesia are maintenance of skin and mucous membrane integrity, safe airway management, prevention of heat and fluid loss, and the provision of effective perioperative analgesia. Several case series have demonstrated that these can be achieved by thorough planning, good communication between clinical teams, and meticulous attention to detail. Treatment of patients with EB in specialized units is optimal as it allows accumulation of knowledge and experience by multidisciplinary teams and education of staff, and facilitates implementation of checklists and protocols to guide care. However, if patients require anesthesia outside such centers, whenever possible personnel with the relevant knowledge and experience should be consulted as part of the planning process. The authors recommend that institutions have the necessary policies and protocols in place, however rarely they may expect to manage such patients.