Anaesthetic management in nonsyndromic craniosynostosis: A pediatric case of fronto-orbital advancement surgery

Vardhan K, Selvi T

Pdf Page Numbers :- 311-313

Kailash Vardhan¹ and Thamarai Selvi^1,*

¹Department of Anaesthesiology and Pain Medicine, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Porur, Chennai – 600116, Tamil Nadu, India

*Corresponding author: Dr. Thamarai Selvi, MBBS, MD (Anaesthesiology), Professor, Department of Anaesthesiology and Pain Medicine, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Porur, Chennai – 600116, Tamil Nadu, India. Email: thamarai@sriramachandra.edu.in

Received 8 April 2025; Revised 10 June 2025; Accepted 18 June 2025; Published 26 June 2025

Citation: Vardhan K, Selvi T. Anaesthetic management in nonsyndromic craniosynostosis: A pediatric case of fronto-orbital advancement surgery. J Med Sci Res. 2025; 13(3):311-313. DOI: http://dx.doi.org/10.17727/JMSR.2025/13-55

Copyright: © 2025 Vardhan K et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

A 17-month-old female child with nonsyndromic right coronal craniosynostosis underwent fronto-orbital advancement under general anaesthesia. Although her condition was nonsyndromic, airway assessment revealed retrognathia and head asymmetry, suggesting a potentially difficult airway. Anticipating difficult airway, video laryngoscopy was used to achieve safe endotracheal intubation. Intraoperative challenges included significant blood loss managed with tranexamic acid and transfusion guided by arterial blood gas monitoring. Postoperative care involved lung-protective ventilation, with successful extubation on the same day. This case highlights the importance of individualized anaesthetic planning and multidisciplinary coordination in achieving optimal outcomes in paediatric craniofacial surgery.

Keywords: craniosynostosis; paediatric anaesthesia; fronto-orbital advancement; difficult airway; video laryngoscopy