[Anesthesia for three patients with Hunter syndrome].

Airway compromise is one of the greatest concerns in the anesthetic management in Hunter syndrome. We report anesthetic management of three cases of Hunter syndrome. The first was a 3-year-old boy scheduled for laparoscopic inguinal hernia repair. A laryngeal mask airway (LMA) was inserted and fiberoptic intubation through the LMA was successfully performed. The second was a 23-year-old man with a past history of difficult intubation, scheduled for repair of femur neck fracture. He received lateral cutaneous nerve block and monitored anesthesia care using remifentanil. The third was a 53-year-old man scheduled for repair of giant inguinal hernia. Having failed regional (combined spinal and epidural) anesthesia, we administered general anesthesia with placement of a LMA. Manual assisted ventilation was needed during operation due to unideal fit. The difficulty of airway management in Hunter syndrome is thought to increase with age. The airway obstruction is one of the most essential problems for anesthesia in these patients. It is important to assess the airway carefully, and to make plans for the anesthesia.