Anaesthetic Management of a Child with Chromosome 7q32.1 Microdeletion Undergoing Ligation of Patent Processus Vaginalis

Abstract

Presentation
A six-year-old boy with chromosome 7q32.1 microdeletion, autism spectrum disorder, attention deficit hyperactivity disorder, hypotonia and asthma presented for elective ligation of a patent processus vaginalis under general anaesthesia.

Diagnosis
Chromosome 7q32.1 microdeletion is a rare genetic disorder with developmental, behavioural and neuromuscular features. Coexisting reactive airway disease and autism spectrum disorder heighten the risk of perioperative respiratory adverse events (PRAEs) and complicate induction and emergence.

Treatment
A perioperative strategy minimising airway stimulation and preserving spontaneous ventilation was employed. Anaesthesia was induced with sevoflurane in oxygen; a laryngeal mask airway (LMA) was used instead of endotracheal intubation, and neuromuscular blockade was avoided. The perioperative course was uneventful, with no respiratory complications.

Discussion
Use of a supraglottic airway with maintenance of spontaneous ventilation, and a calm behaviourally tailored approach, facilitated safe anaesthesia in this child. This case adds to the limited literature on the anaesthetic implications of chromosome 7q32.1 microdeletion.