Anesthetic Management of Inguinal Hernia Surgery in an Adult Patient With Arthrogryposis Multiplex Congenita: A Case Report

TL;DR

This case report describes a safe anesthetic approach for an adult with arthrogryposis undergoing hernia surgery, avoiding general anesthesia.

Contribution

Presents a novel regional anesthesia strategy for adult AMC patients, addressing limited anesthetic guidelines for this rare condition.

Findings

Ultrasound-guided nerve blocks with dexmedetomidine sedation were successfully used in an adult AMC patient.

Avoiding endotracheal intubation and volatile anesthetics reduced anesthetic risks in this high-risk case.

Regional anesthesia offers a viable alternative for AMC patients undergoing inguinal hernia repair.

Abstract

Arthrogryposis multiplex congenita (AMC) poses major anesthetic challenges due to severe joint contractures, airway restrictions, and a debated risk of malignant hyperthermia. Despite these complexities, anesthetic reports in adult AMC patients remain extremely limited, leaving perioperative management largely unstandardized. We present the anesthetic approach for a 35-year-old male patient with AMC undergoing open inguinal hernia repair. Given the high risk of airway compromise and joint immobility, we opted for ultrasound-guided ilioinguinal and iliohypogastric nerve blocks with dexmedetomidine sedation, avoiding endotracheal intubation and volatile anesthetics. This case highlights regional anesthesia as a critical alternative to general anesthesia, providing valuable insights into safe, tailored anesthetic strategies for this rare and underreported population.

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