Shy-Drager syndrome. A review and a description of the anaesthetic management

Autonomic failure in patients with the Shy-Drager syndrome may produce cardiovascular instability during anaesthesia and surgery. The syndrome is reviewed and the anaesthetic management of a case is described. The choice between general and regional anaesthesia seems to be less important than adequa...

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Bibliographic Details
Published inAnaesthesia Vol. 34; no. 9; p. 866
Main Author Bevan, D R
Format Journal Article
LanguageEnglish
Published England 01.10.1979
Subjects
Anesthesia, General
Autonomic Nervous System - physiopathology
Female
Humans
Hypotension, Orthostatic - physiopathology
Hypotension, Orthostatic - therapy
Intestinal Obstruction - surgery
Kidney Diseases - physiopathology
Kidney Diseases - therapy
Male
Middle Aged
Monitoring, Physiologic
Nervous System Diseases - physiopathology
Nervous System Diseases - therapy
Syndrome
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Summary:Autonomic failure in patients with the Shy-Drager syndrome may produce cardiovascular instability during anaesthesia and surgery. The syndrome is reviewed and the anaesthetic management of a case is described. The choice between general and regional anaesthesia seems to be less important than adequate cardiovascular monitoring and the maintenance of blood pressure with intravenous fluids. Sympathomimetic drugs, if used at all, should be administered in very dilute solutions to avoid hypertension from denervation hypersensitivity. In the postoperative period, symptoms from orthostatic hypotension may be severe and their control requires prolonged postural training, by elevation of the head of the bed, and therapy with 9-alpha-fludrocortisone.
ISSN:0003-2409
DOI:10.1111/j.1365-2044.1979.tb08537.x