Desflurane for management of decompressive laminectomy in a patient with hereditary spastic paraplegia: a case report

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...

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Bibliographic Details
Published in:JA clinical reports 2019-04, Vol.5 (1), p.30-4, Article 30
Main Authors: Tada, Masahiro, Tateoka, Kazuyoshi, Yamamoto, Kenji, Inagaki, Yasuyoshi, Kunisawa, Takayuki
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesiology
Case Report
Case reports
Critical Care Medicine
Desflurane
Emergency Medicine
General anesthesia
Hereditary spastic paraplegia
Intensive
Medicine
Medicine & Public Health
Neuromuscular diseases
Pain Medicine
Paralysis
Rocuronium
Spasticity
Sugammadex
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Summary: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.
ISSN:2363-9024
2363-9024
DOI:10.1186/s40981-019-0250-1