Anaesthetic Management of an Achondroplastic Dwarf with Difficult Airway and Spine for Total Hip Replacement: A Case Report

Achondroplasia is the commonest form of dwarfism and possesses multiple anesthetic challenges ranging from securing intravenous line, monitoring and calculating drug dosage to abnormalities of the airway, spine, thoracic cage, and obesity, cardiopulmonary and neurological system. Multiple case reports describing neuraxial anaesthesia, particularly in obstetrics patients are available but there are limited literature on airway management and general anaesthesia. We came across an achondroplastic dwarf for hip replacement with spine deformity where neuraxial anaesthesia was impossible and her difficult airway and chronic lung disease imposed serious anesthetic challenges. We describe the importance of awake fiberoptic intubation (FOI) for airway management and general anaesthesia in this patient with difficult airway and spine and restrictive lung disease for total hip replacement.