Use of propofol anesthesia during outpatient radiographic imaging studies in patients with Lesch-Nyhan syndrome

Karen Stanley Williams, James G. Hankerson, Monique Ernst, Alan Zametkin

Research output: Contribution to journalArticle

Abstract

Lesch-Nyhan syndrome is a rare, x-linked, recessive disorder of purine metabolism resulting in hyperuricemia, spasticity, choreoathetosis, dystonia, self-injurious behavior, and aggression, without significant cognitive impairment. Anesthetic management of inpatients who demonstrate classic manifestations of Lesch-Nyhan syndrome and require surgical interventions have been described. There are no guidelines in the literature addressing the anesthetic management of the outpatient with Lesch-Nyhan syndrome. Specifically, sudden, unexplained death, abnormalities in respiration, apnea, severe bradycardia, and an increased incidence of vomiting and chronic pulmonary aspiration may preclude this patient population from receiving anesthesia for outpatient procedures. General anesthesia with spontaneous ventilation was performed for diagnostic, radiographic imaging in 11 outpatients with Lesch-Nyhan syndrome using intravenous propofol. A bolus with dose of 1.5 to 2.0 mg/kg propofol was followed by maintenance doses of 60 to 160 mcg/kg/min. Results during and following sedation indicated end-tidal carbon dioxide ranges between 34 mmHg and 59 mmHg. Respiratory rates were never below 10 breaths/min and no partial/complete airway obstruction or labored breathing was clinically evident. Hemodynamics were within 30% of presedation values. No patient demonstrated nausea, vomiting, or pulmonary aspiration. Baseline neuropsychologic status was achieved following sedation, and patients were discharged from the hospital 35 to 90 minutes after sedation was completed. Potential risks and benefits of using propofol in this patient population are discussed.

Original languageEnglish (US)
Pages (from-to)61-65
Number of pages5
JournalJournal of Clinical Anesthesia
Volume9
Issue number1
DOIs
StatePublished - Feb 1997
Externally publishedYes

Fingerprint

Lesch-Nyhan Syndrome
Propofol
Outpatients
Anesthesia
Vomiting
Anesthetics
Respiration
Self-Injurious Behavior
Lung
Hyperuricemia
Dystonia
Apnea
Airway Obstruction
Diagnostic Imaging
Bradycardia
Respiratory Rate
Sudden Death
Aggression
Carbon Dioxide
General Anesthesia

Keywords

  • Anesthesia, ambulatory
  • Lesch-Nyhan syndrome
  • propofol

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Use of propofol anesthesia during outpatient radiographic imaging studies in patients with Lesch-Nyhan syndrome. / Williams, Karen Stanley; Hankerson, James G.; Ernst, Monique; Zametkin, Alan.

In: Journal of Clinical Anesthesia, Vol. 9, No. 1, 02.1997, p. 61-65.

Research output: Contribution to journalArticle

Williams, Karen Stanley ; Hankerson, James G. ; Ernst, Monique ; Zametkin, Alan. / Use of propofol anesthesia during outpatient radiographic imaging studies in patients with Lesch-Nyhan syndrome. In: Journal of Clinical Anesthesia. 1997 ; Vol. 9, No. 1. pp. 61-65.
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