Airway management and quadratus lumborum block for inguinal hernia repair in context of Chromosome 4q deletion: A case report and literature review
Authors: Katie Lovell1, Michael C. Larkins1, Melisa Pasli1, Adrienne H. Singleton1,2
1East Carolina University Brody School of Medicine, 600 Moye Blvd Greenville, NC USA 2East Carolina Anesthesia Associates, 2080 W Arlington Blvd, Greenville, NC, USA
Correspondence: Adrienne Singleton
East Carolina Anesthesia Associates
2430 Emerald Pl #103, Greenville NC, 27834
asingleton@ecaa.com
Office Phone: 252-752-2140
Word Count: 1,585
Abstract: Chromosome 4q Deletion Syndrome (4QDS) is a rare chromosomal deletion with the potential for congenital defects that could affect the anesthetic management of affected patients. We present a report of a patient with known 4QDS who underwent successful general anesthetic induction and tracheal intubation, followed by subsequent bilateral quadratus lumborum nerve blocks, in the context of laparoscopic inguinal hernia repair surgery. Given the inconsistent presentation of patients with 4QDS reported in the literature, steps were taken to exercise sufficient caution concerning the overall management of this patient per the most recent guidelines for pediatric patients.
Key Clinical Message:  Chromosome 4q Deletion Syndrome (4QDS) is a rare chromosomal deletion that presents with various congenital defects that could affect the anesthetic management. We present a patient with known 4QDS who underwent successful general anesthetic induction, tracheal intubation, and subsequently, bilateral quadratus lumborum nerve blocks, during laparoscopic inguinal hernia repair surgery.
Keywords : Chromosome 4q Deletion Syndrome, Congenital Airway Malformations, Challenging Pediatric Airway, Congenital Airway Malformations, Quadratus Lumborum Block, Regional Anesthesia