{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T17:39:46Z","timestamp":1773337186125,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Shandong Provincial Medical Association","award":["YXH2025YS085"],"award-info":[{"award-number":["YXH2025YS085"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Mucopolysaccharidosis (MPS) is a group of rare inherited lysosomal storage disorders caused by deficiencies of specific enzymes, leading to abnormal accumulation of glycosaminoglycans in tissues throughout the body. It is often associated with a difficult airway, cervical spine instability, restrictive pulmonary dysfunction, and cardiovascular pathologies, which significantly increase perioperative risks. This manuscript reports a case of a 36-year-old male MPS patient (clinical phenotype highly suggestive of type IV) who underwent right mid-to-upper thigh amputation for a pathological fracture of the right femur. Given his potential difficult airway (Mallampati class III, thyromental distance &amp;lt;6\u202fcm), mild kyphosis, and restrictive pulmonary dysfunction, the anesthetic plan consisted of an ultrasound-guided one-point puncture, dual-target lumbosacral plexus block (35\u202fmL of 0.15% ropivacaine) combined with supraglottic airway (laryngeal mask airway, LMA) under general anesthesia. The block successfully provided an L2-S3 sensory level and served as the basis for postoperative multimodal analgesia. The surgery lasted 2\u202fh with 500\u202fmL blood loss, requiring 2\u202funits of red blood cells. Hemodynamics remained stable, and no additional muscle relaxants were administered. The patient regained consciousness and the LMA was removed 10\u202fmin postoperatively. The Numerical Rating Scale (NRS) pain scores at 2, 6, 12, and 24\u202fh postoperatively were 2, 3, 2, and 1, respectively. Functional exercise began on postoperative day 1 without major complications. The patient was discharged 15\u202fdays after surgery and was hospitalized for a total of 18\u202fdays. With strict patient selection and thorough preparation of emergency airway protocols, combining an LMA with an ultrasound-guided one-point puncture lumbosacral plexus block can be a safe and feasible individualized anesthetic strategy for lower limb proximal surgery in MPS patients. This approach helps avoid intubation risks, reduces opioid consumption, and promotes early recovery. However, due to the considerable difficulty of airway management in patients with MPS, elective surgery requires multidisciplinary consultation and comprehensive airway assessment to ensure perioperative safety.<\/jats:p>","DOI":"10.3389\/fmed.2026.1790821","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:47:51Z","timestamp":1773298071000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-guided one-point puncture lumbosacral plexus block combined with laryngeal mask airway general anesthesia for thigh amputation in a patient with mucopolysaccharidosis: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Shengrun","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, The 960th Hospital of PLA","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junfeng","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The 960th Hospital of PLA","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengjie","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The 960th Hospital of PLA","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The 960th Hospital of PLA","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2515","DOI":"10.3390\/ijms21072515","article-title":"Pathogenesis of Mucopolysaccharidoses, an 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arthroplasty","volume":"15","author":"Jiang","year":"2025","journal-title":"Sci Rep"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/8692966","article-title":"Effects of lumbar plexus block combined with infiltration anesthesia on anesthesia comfort scores and stress responses in elderly patients undergoing hip replacement","volume":"2022","author":"Zhang","year":"2022","journal-title":"Dis Markers"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1055\/s-0038-1676477","article-title":"Pain management in enhanced recovery after surgery (ERAS) protocols","volume":"32","author":"Simpson","year":"2019","journal-title":"Clin Colon Rectal Surg"}],"container-title":["Frontiers in 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