Navigating Anesthesia in Fragile Patients: A Case Report on Esophageal Dilation in a 9-Year-Old Patient With Epidermolysis Bullosa.

Epidermolysis bullosa (EB) is a rare genetic disorder causing fragile skin and mucous membranes, leading to blistering from minor trauma. Managing anesthesia in EB patients is challenging due to their delicate airways, limited mobility, and need for repeated surgeries. We describe the perioperative management of a 9-year-old girl with dystrophic EB undergoing esophageal dilation. Preoperative assessment showed limited mouth opening, poor dentition, restricted neck movement, and extensive scarring, requiring a difficult airway approach. Anesthesia was induced intravenously, and intubation was successful on the first attempt using a lubricated video laryngoscope and cuffed tube, avoiding trauma. Monitoring was adapted to eliminate adhesives, and padding was used to prevent new blisters. The procedure was completed without complications, and extubation was performed while the patient was awake. This highlights the importance of preparation, teamwork, and tailored anesthetic techniques to ensure safety in EB patients, helping reduce risks and guiding management.