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Perioperative Management of Lewis-Sumner Syndrome
Lewis-Sumner syndrome (LSS) is a rare immune-mediated neuromuscular disorder. It shares some clinical and pathological features with chronic inflammatory demyelinating polyneuropathy (CIDP). We report on the anaesthetic management of a patient with LSS. There are several concerns when anaesthetizing...
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Published in: | Curēus (Palo Alto, CA) CA), 2023-03, Vol.15 (3), p.e36297 |
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creator | Sales, Filipa Cruz, Ana Raquel S Maldonado, Filipa Cunha, Mariana |
description | Lewis-Sumner syndrome (LSS) is a rare immune-mediated neuromuscular disorder. It shares some clinical and pathological features with chronic inflammatory demyelinating polyneuropathy (CIDP). We report on the anaesthetic management of a patient with LSS. There are several concerns when anaesthetizing patients with demyelinating neuropathies, the main ones being the post-operative worsening of symptoms and respiratory depression related to muscle relaxants. In our experience, the rocuronium effect was prolonged and an even lower dosage (0.4 mg/kg) was sufficient for intubation and maintenance. Sugammadex allowed total reversion of neuromuscular block and no respiratory complications occurred. In conclusion, the combination of lower dose rocuronium and sugammadex was safely used in a patient with LSS. |
doi_str_mv | 10.7759/cureus.36297 |
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It shares some clinical and pathological features with chronic inflammatory demyelinating polyneuropathy (CIDP). We report on the anaesthetic management of a patient with LSS. There are several concerns when anaesthetizing patients with demyelinating neuropathies, the main ones being the post-operative worsening of symptoms and respiratory depression related to muscle relaxants. In our experience, the rocuronium effect was prolonged and an even lower dosage (0.4 mg/kg) was sufficient for intubation and maintenance. Sugammadex allowed total reversion of neuromuscular block and no respiratory complications occurred. In conclusion, the combination of lower dose rocuronium and sugammadex was safely used in a patient with LSS.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.36297</identifier><identifier>PMID: 37073183</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Anesthesiology ; General anesthesia ; Guillain-Barre syndrome ; Hemoglobin ; Hyperkalemia ; Intubation ; Medical personnel ; Muscle strength ; Neurology ; Oxygen saturation ; Patients ; Postoperative period ; Regional anesthesia ; Surgery ; Ventilation</subject><ispartof>Curēus (Palo Alto, CA), 2023-03, Vol.15 (3), p.e36297</ispartof><rights>Copyright © 2023, Sales et al.</rights><rights>Copyright © 2023, Sales et al. This work is published under https://creativecommons.org/licenses/by/3.0/ (the “License”). 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It shares some clinical and pathological features with chronic inflammatory demyelinating polyneuropathy (CIDP). We report on the anaesthetic management of a patient with LSS. There are several concerns when anaesthetizing patients with demyelinating neuropathies, the main ones being the post-operative worsening of symptoms and respiratory depression related to muscle relaxants. In our experience, the rocuronium effect was prolonged and an even lower dosage (0.4 mg/kg) was sufficient for intubation and maintenance. Sugammadex allowed total reversion of neuromuscular block and no respiratory complications occurred. In conclusion, the combination of lower dose rocuronium and sugammadex was safely used in a patient with LSS.</description><subject>Anesthesiology</subject><subject>General anesthesia</subject><subject>Guillain-Barre syndrome</subject><subject>Hemoglobin</subject><subject>Hyperkalemia</subject><subject>Intubation</subject><subject>Medical personnel</subject><subject>Muscle strength</subject><subject>Neurology</subject><subject>Oxygen saturation</subject><subject>Patients</subject><subject>Postoperative period</subject><subject>Regional anesthesia</subject><subject>Surgery</subject><subject>Ventilation</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpVkF1LwzAUhoMobszdeS0Fb-08SZqvK5HhF0wUptchzdLZsTYzaSf791Y3x7zKgTy85z0PQucYRkIwdW3b4No4opwocYT6BHOZSiyz44O5h4YxLgAAgyAg4BT1qABBsaR9hF9dKP3KBdOUa5c8m9rMXeXqJvFFMnFfZUynbVW7kEw39Sz4yp2hk8Isoxvu3gF6v797Gz-mk5eHp_HtJLUUQ5OSjDIisbHMAMeWA6ccTOaoLLDKGJMO50Yals9UbnHBcsuIoUzYDDKhCKcDdLPNXbV55Wa26xTMUq9CWZmw0d6U-v9PXX7ouV9r3B3KMWRdwuUuIfjP1sVGL3wb6q60JhKEJFJJ1VFXW8oGH2NwxX4FBv0jWW8l61_JHX5xWGsP_yml32wpeCo</recordid><startdate>20230317</startdate><enddate>20230317</enddate><creator>Sales, Filipa</creator><creator>Cruz, Ana Raquel S</creator><creator>Maldonado, Filipa</creator><creator>Cunha, Mariana</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20230317</creationdate><title>Perioperative Management of Lewis-Sumner Syndrome</title><author>Sales, Filipa ; 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It shares some clinical and pathological features with chronic inflammatory demyelinating polyneuropathy (CIDP). We report on the anaesthetic management of a patient with LSS. There are several concerns when anaesthetizing patients with demyelinating neuropathies, the main ones being the post-operative worsening of symptoms and respiratory depression related to muscle relaxants. In our experience, the rocuronium effect was prolonged and an even lower dosage (0.4 mg/kg) was sufficient for intubation and maintenance. Sugammadex allowed total reversion of neuromuscular block and no respiratory complications occurred. In conclusion, the combination of lower dose rocuronium and sugammadex was safely used in a patient with LSS.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>37073183</pmid><doi>10.7759/cureus.36297</doi><oa>free_for_read</oa></addata></record> |
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subjects | Anesthesiology General anesthesia Guillain-Barre syndrome Hemoglobin Hyperkalemia Intubation Medical personnel Muscle strength Neurology Oxygen saturation Patients Postoperative period Regional anesthesia Surgery Ventilation |
title | Perioperative Management of Lewis-Sumner Syndrome |
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