Anesthetic Management of a Pediatric Patient With Glucose-6-Phosphate Dehydrogenase Deficiency Undergoing Emergency Rigid Esophagoscopy: A Case Report.

A 23-month-old, 8-kg boy with known glucose-6-phosphate dehydrogenase (G6PD) deficiency presented with a coin lodged in the upper esophagus and required urgent rigid esophagoscopy under general anesthesia. Anesthetic management was planned to avoid drugs with oxidative potential and to minimize physiologic stressors that could contribute to hemolysis or methemoglobinemia. General anesthesia was performed using agents considered safe in patients with G6PD deficiency, with intraoperative management focused on maintaining normoxia using the lowest possible inspired oxygen concentration needed to maintain oxygen saturation above 95%, normothermia, and hemodynamic stability. The foreign body was removed without complications, and there were no clinical signs of hemolysis or methemoglobinemia during hospitalization. Postoperative monitoring included serial hemoglobin assessment and clinical surveillance for jaundice and dark urine for more than 24 hours, with no evidence of delayed hemolysis. A follow-up phone call at 72 hours confirmed that there were no symptoms. This case highlights a practical perioperative approach to emergent pediatric anesthesia in a patient with G6PD deficiency, emphasizing careful drug selection and proactive prevention and monitoring of oxidative triggers.