Anesthesia and Epidermolysis Bullosa




Patients with epidermolysis bullosa (EB) may present for anesthesia with an unrelated surgical condition or, more commonly, for diagnostic or therapeutic procedures. Children in particular may require frequent anesthetics. Safe and effective management of anesthesia presents a significant challenge and although there is little rigorous evidence available to aid decision-making, in this article the elements of current good anesthesia care in EB are summarized.


Patients with epidermolysis bullosa (EB) may present for anesthesia with an unrelated surgical condition or, more commonly, for diagnostic or therapeutic procedures. Children in particular may require frequent anesthetics. Safe and effective management of anesthesia presents a significant challenge and although there is little rigorous evidence available to aid decision-making, in this article the elements of current good anesthesia care in EB are summarized.


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.

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Feb 12, 2018 | Posted by in Dermatology | Comments Off on Anesthesia and Epidermolysis Bullosa

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