Anesthesia management for posterior correction of scoliosis in a child with absence of the right pulmonary artery: a case report

Objective To discuss the perioperative anesthesia management strategy for posterior correction of scoliosis in children with unilateral absence of pulmonary artery (UAPA). Methods Clinical data of one case of an adolescent male with absence of right pulmonary artery receiving posterior scoliosis correction surgery was retrospectively collected; the preoperative evaluation, intraoperative anesthesia management and postoperative pain treatment were analyzed and summarized. Results UAPA is a rare congenital cardiovascular anomaly that can further increase the cardiovascular and respiratory risks of surgical treatment in scoliosis patients. As the patient was concurrent with hemoptysis, after multidisciplinary consultation and evaluation, an emergency plan for hemoptysis was developed, and invasive arterial pressure monitoring, sufficient analgesia, close respiratory monitoring, and lung protective ventilation strategy was performed intraoperatively. Ensuring respiratory function after surgery, multimodal analgesia was administered. Confirming satisfactory treatment results, the patient was discharged from the hospital. Conclusions For symptomatic UAPA patients, clinicians should focus on the circulation and respiratory system, maintain perioperative hemodynamic stability, prevent hypoxia and carbon dioxide retention so to reduce the risk of complications.