Anesthetic Management of a Patient with Congenital Insensitivity to Pain with Anhidrosis Measuring the Plasma Catecholamine Levels

Abstract

  We experienced successful anesthetic management of a patient with congenital insensitivity to pain with anhidrosis for the amputation of the big toe. Anesthesia was maintained by propofol infusion under Bispectral Index monitoring. In order to observe sympathetic reaction to surgical stimulations, we measured the plasma catecholamine levels before and during surgery. Plasma catecholamine levels did not differ between two measurement points. This result indicates that there is no sympathetic reaction during the surgical stimulations in the patient with congenital insensitivity to pain with anhidrosis.