Pain protects the body from damaging effects of harmful stimuli.
Congenital insensitivity to pain is a rare inherited disorder characterized by diminished or absent sensitivity to
pain, touch, and pressure that leads to frequent
trauma and
self-mutilation. The disorder is part of the hereditary sensory and autonomic neuropathy (
HSAN) family, in which 5 types have been recognized. Research and case reports of
anesthetic risks and
analgesic needs of these patients is limited due to the infrequent nature of the disorder. Recommendations for
anesthesia include modification of intraoperative
opioid requirements, use of
anesthetics to ensure cooperation and immobility, and intraoperative temperature monitoring. It is imperative for
anesthesia providers to understand which type of
HSAN their patient experiences and to conduct a thorough preoperative interview because a different interpretation of sensory loss may occur in each
HSAN category. This article reports the case of a patient with
HSAN type 2 who presented for knee arthroscopy.