The Debatable Dilemma- A Case of Anaesthetic Dental Trauma in a Syndromic Patient: Unavoidable or Negligence?

Perioperative tissue damage is one of the most common anaesthesia-related adverse events and is responsible for the greatest number of malpractice claims against anaesthesiologists. Damage to the teeth during general anaesthesia is a frequent cause of morbidity for patients and a source of litigation against anaesthetists. Mucopolysaccharidoses (MPSs) are a group of uncommon genetic disease of connective tissue metabolism. Hunter syndrome (HS), or mucopolysaccharidosis II (MPS II), is a lysosomal storage disease caused by a deficient or absent enzyme- iduronate-2-sulfatase (I2S). It is well established that the elective treatment of subjects affected by MPS is multidisciplinary and must be carried out by experienced personnel in highly specialist centres. A thorough evaluation may necessitate a dentist's help, requiring that anaesthesiologists receive more formal training regarding oral and dental anatomy, and enables performing the treatments necessary to minimize the risks of dental injuries. Various attempts to produce guidelines have been made for MPS. We want to provide a summary of anaesthetic management for these high-risk patients, who require surgical procedures and diagnostic examinations under sedation with a higher frequency than the general population.