Airway management and quadratus lumborum block for inguinal
hernia repair in context of Chromosome 4q deletion: A case report and
literature review
Authors: Katie Lovell1, Michael C.
Larkins1, Melisa Pasli1, Adrienne H.
Singleton1,2
1East Carolina University Brody School of Medicine,
600 Moye Blvd Greenville, NC USA 2East Carolina
Anesthesia Associates, 2080 W Arlington Blvd, Greenville, NC, USA
Correspondence: Adrienne Singleton
East Carolina Anesthesia Associates
2430 Emerald Pl #103, Greenville NC, 27834
asingleton@ecaa.com
Office Phone: 252-752-2140
Word Count: 1,585
Abstract: Chromosome 4q Deletion Syndrome (4QDS) is a rare
chromosomal deletion with the potential for congenital defects that
could affect the anesthetic management of affected patients. We present
a report of a patient with known 4QDS who underwent successful general
anesthetic induction and tracheal intubation, followed by subsequent
bilateral quadratus lumborum nerve blocks, in the context of
laparoscopic inguinal hernia repair surgery. Given the inconsistent
presentation of patients with 4QDS reported in the literature, steps
were taken to exercise sufficient caution concerning the overall
management of this patient per the most recent guidelines for pediatric
patients.
Key Clinical Message: Chromosome 4q Deletion Syndrome (4QDS)
is a rare chromosomal deletion that presents with various congenital
defects that could affect the anesthetic management. We present a
patient with known 4QDS who underwent successful general anesthetic
induction, tracheal intubation, and subsequently, bilateral quadratus
lumborum nerve blocks, during laparoscopic inguinal hernia repair
surgery.
Keywords : Chromosome 4q Deletion Syndrome, Congenital Airway
Malformations, Challenging Pediatric Airway, Congenital Airway
Malformations, Quadratus Lumborum Block, Regional Anesthesia