Anesthesia Considerations for Transfemoral Osseointegration in a Patient With CRPS, Propofol, and Ketamine Allergies: A Case Report.
4 affiliations
- 1College of Medicine Drexel University Philadelphia Pennsylvania USA drexel.edu.
- 2Osseointegration Limb Replacement Center Hospital for Special Surgery New York New York USA hss.edu.
- 3Department of Anesthesiology Weill Cornell Medical College New York New York USA cornell.edu.
- 4Department of Anesthesiology, Critical Care and Pain Management Hospital for Special Surgery New York New York USA hss.edu.
Abstract
A 20-year-old female with asthma, Ehlers-Danlos syndrome, Hashimoto's thyroiditis, mast cell activation syndrome, and complex regional pain syndrome Type 1 (CRPS1) presented for left transfemoral amputation with osseointegration and nerve reconstruction. To limit CRPS1 exacerbation, neuraxial anesthesia with femoral and sciatic blocks was administered for analgesia. Given the reported history of convulsions following ketamine and propofol, sedation with midazolam, dexmedetomidine, and fentanyl was used. On POD 1, fascia iliaca and sciatic blocks were repeated to mitigate postoperative pain. There were no intraoperative or postoperative complications. With limited literature on anesthesia for osseointegration, this novel case highlights individualized planning, in the setting of adverse responses to anesthetic medications and challenging pain management.
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BibTeX
@article{fanizza2026anesthesia,
title = {{Anesthesia Considerations for Transfemoral Osseointegration in a Patient With CRPS, Propofol, and Ketamine Allergies: A Case Report.}},
author = {Jake D Fanizza and Jason Shih Hoellwarth and Uchenna O Umeh},
journal = {Case reports in anesthesiology},
year = {2026},
month = oct,
doi = {10.1155/cria/6532945},
url = {https://europepmc.org/article/MED/42909998},
note = {CC BY},
}
RIS
TY - JOUR
TI - Anesthesia Considerations for Transfemoral Osseointegration in a Patient With CRPS, Propofol, and Ketamine Allergies: A Case Report.
AU - Jake D Fanizza
AU - Jason Shih Hoellwarth
AU - Uchenna O Umeh
PY - 2026
DA - 2026/10/21
JO - Case reports in anesthesiology
DO - 10.1155/cria/6532945
UR - https://europepmc.org/article/MED/42909998
AB - A 20-year-old female with asthma, Ehlers-Danlos syndrome, Hashimoto's thyroiditis, mast cell activation syndrome, and complex regional pain syndrome Type 1 (CRPS1) presented for left transfemoral amputation with osseointegration and nerve reconstruction. To limit CRPS1 exacerbation, neuraxial anesthesia with femoral and sciatic blocks was administered for analgesia. Given the reported history of convulsions following ketamine and propofol, sedation with midazolam, dexmedetomidine, and fentanyl was used. On POD 1, fascia iliaca and sciatic blocks were repeated to mitigate postoperative pain. There were no intraoperative or postoperative complications. With limited literature on anesthesia for osseointegration, this novel case highlights individualized planning, in the setting of adverse responses to anesthetic medications and challenging pain management.
SN - 2090-6382
SN - 2090-6390
ER -