[Epidural anesthesia in a child with femoral fracture and congenital pain insensitivity].

An 8-year-old boy with congenital insensitivity to pain underwent open reduction of a fractured femur with osteosynthesis under epidural block, without complications and with intraoperative hemodynamic stability. The postoperative course was favorable with minimal analgesia. Congenital insensitivity to pain is a rare hereditary condition characterized by abnormal response to painful stimuli and associated with orthopedic complications requiring surgery. Anesthesia is essential because, even though pain is absent, autonomic dysfunction and catecholamine metabolism alterations are present. An epidural block can be recommended for patients with congenital insensitivity to pain who must undergo surgery.