Abstract
Costello syndrome is an inherited disease and characterized by postnatal growth deficiency, coarse face, papillomata, and redundant skin. There is limited information available on the anesthetic management of a patient with Costello syndrome. We report the anesthetic management of an 11-year-old girl with Costello syndrome who underwent transurethral resection of a bladder tumor. Anesthesia was induced with sevoflurane in nitrous oxide and oxygen. During induction of general anesthesia, face mask ventilation was easily performed. We tried to intubate the trachea with muscle relaxation, but it was impossible to identify the larynx. After several unsuccessful attempts, the trachea was intubated blindly. Anesthesia was uneventful using sevoflurane and nitrous oxide.On the 13th postoperative day, she underwent an operation for bladder tamponade. In view of the difficult intubation and the occurrence of papillomata related to the endotracheal stimulation, anesthesia was completed using a breathing mask. The considerations regarding the difficult airway and the occurrence of papillomata are essential in the anesthetic management of a patient with Costello syndrome.
