Aaron A Berg
Epidermolysis Bullosa (EB) poses challenges to anesthesiologists due to difficulty maintaining skin integrity with interventions contacting the skin. Complications during all types of anesthesia are created by needs for monitoring and securing access, potentially creating blisters and bullae from friction and shearing forces. Also, due to EB patients having a higher opioid tolerance from prolonged use and being in a hypermetabolic state, adequate pain control is more difficult to achieve. This case report details the decision process and management of a pediatric patient who received bilateral infraclavicular catheters for bilateral syndactyly procedure. Epidermolysis Bullosa poses unique challenges for anesthesia care due to interventions that test skin integrity and management of chronic pain commonly controlled by opioids. Cather placement for perioperative pain has been infrequently documented as a solution to pain control due to concerns of causing blister and bullae formation. Bilateral infraclavicular catheters used for postoperative pain management were successfully utilized in a pediatric patient with Epidermolysis Bullosa.
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