Management of Anesthesia and Perioperative Procedures in a Child with Glucose-6-Phosphate Dehydrogenase Deficiency

Abstract

Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that helps red blood cells work properly; it participates in the production of antioxidants and helps to defend cells against oxidative damage. With all this in mind, patients with G6PD deficiency may be very sensitive and vulnerable to different oxidative stressors, because they can cause some serious medical conditions of which hemolytic anemia is common in adults and severe jaundice in newborns. The most common triggers of hemolysis in G6PD deficiency are infections, medications, metabolic conditions such as diabetic ketoacidosis, hypothermia, and a very important item—surgical stress. During the operative period, the anesthetic goal is to reduce stress and monitor if the hemolysis occurs, and of course, treat it if it occurs. In our case, the combination of sevoflurane inhalation anesthesia with the addition of sufentanil proved to be safe and effective in the management of a child with G6PD deficiency.