A case report of a child with Pompe's disease (glycogen storage disease type II), who underwent two general anesthetics, is presented. The progressive infiltration of heart and skeletal muscle with glycogen results in a severe form of cardiomyopathy and respiratory muscle weakness. Death usually occurs by 1 year of age from respiratory insufficiency or end-stage cardiomyopathy. Consequently, there are significant problems in the anesthetic management of these patients. The patient, a female child of 6 months presented signs of cardiac failure and took treatment with olprinone and diuretic. The initial surgical procedure was placement of a subcutaneous central venous catheter. Anesthesia was induced with ketamine and midazolam intravenously, and was maintained with nitrous oxide (50%) and intravenous ketamine. The dosage of the dopamine and olprinone was necessary to maintain circulation. For tracheotomy, the second procedure, anesthesia was induced and maintained with sevoflurane and dopamine. Recently a promising enzyme replacement therapy has resulted in improved clinical outcomes, and the number of anesthesia for infants of with Pompe's disease will increase in future.
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