CASE REPORT: Anaesthetic Management of An Adult Patient with Homocystinuria and Dystonia Undergoing Orthopaedic Surgery: A Case Report

Abstract

hypercoagulability and metabolic stress. Anaesthetic management in adult patients undergoing non-ocular surgery has rarely been reported. We describe the anaesthetic management of a 29-year-old man with homocystinuria, marfanoid features, and dystonia who underwent elective orthopaedic foot surgery.
Perioperative care focused on minimizing thromboembolic and metabolic risks through reduced fasting duration, maintenance of normothermia and adequate hydration, avoidance of nitrous oxide, and use of mechanical thromboprophylaxis. General anaesthesia was administered using a laryngeal mask airway with sevoflurane and atracurium. The intraoperative and postoperative courses were uneventful, and the patient was discharged on the same day of the surgery. This case highlights that with careful, physiologically guided planning, safe anaesthesia can be achieved in adult patients with homocystinuria, even in resource-limited settings.