Navigating the narrow path: Dexmedetomidine infusion in a child with Arnold-Chiari malformation for bilateral cochlear implantation.

Abstract

Bilateral cochlear implantation in young children is the standard of care for severe hearing loss not amenable to standard hearing aids. Anaesthetic challenges in a child with Arnold Chiari malformation for cochlear implant  include difficult paediatric airway compounded by congenital malformations,abnormalities of  spine, difficulty in  positioning for optimum laryngoscopy in addition to challenges as a result of the pathophysiology itself. Here with presenting a 4 year old child who was posted for bilateral cochlear implantation under general anaesthesia with controlled ventilation. Dexmedetomidine infusion in low dose helped to achieve haemodynamic stability with good intraoperative and post-operative analgesia, bloodless surgical field without affecting the recovery and offering smooth extubation without any delay.