Successful formula reported in a recent study
Great care and skilful planning are needed for people with HSP who require a general anaesthetic. This case study details a successful anaesthesia process.
BACKGROUND: Hereditary spastic paraplegia (HSP) is a rare, genetic neurodegenerative condition. Thus far, ideal anesthetic management is not established for patients with HSP; therefore, careful selection and dosage of anesthetic agents is required.
CASE PRESENTATION: A 54-year-old woman with HSP, who was diagnosed with severe lumbar spinal canal stenosis, underwent decompressive laminectomy to relieve her back pain. Preoperatively, she experienced slight difficulty in walking independently; however, she exhibited no other dysfunction. Anesthesia was maintained with desflurane after tracheal intubation. Rocuronium and sugammadex were used for neuromuscular blockade and reversal, respectively, with neuromuscular monitoring equipment. The patient showed uneventful postoperative recovery without signs of neurological deterioration after extubation.
CONCLUSIONS: Our successful experience in this case implies that, for patients with neuromuscular diseases, including HSP, desflurane may be an option for anesthetic management; moreover, careful assessment (e.g., medical condition, bispectral index, and train-of-four) should be performed prior to administration of anesthesia.
SOURCE: JA Clin Rep. 2019 Apr 30;5(1):30. doi: 10.1186/s40981-019-0250-1. PMID: 32025921
Desflurane for management of decompressive laminectomy in a patient with hereditary spastic paraplegia: a case report.
1 Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan. [email protected]
2 Department of Anesthesiology, National Hospital Organization Obihiro Hospital, Obihiro, Hokkaido, Japan. [email protected]
3 Department of Anesthesia, Nayoro City General Hospital, Nayoro, Hokkaido, Japan.
4 Department of Emergency Medicine, Nayoro City General Hospital, Nayoro, Hokkaido, Japan.
5 Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan.