Anesthetic management of two patients with amyotrophic lateral sclerosis (ALS)

We experienced anesthetic management of two cases of amyotrophic lateral sclerosis (ALS). Case 1. A 46-year-old woman underwent emergency operation for ileus. Abdominal muscle relaxation and analgesia were obtained by combined spinal and epidural anesthesia. To avoid prolongation of muscle relaxatio...

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Bibliographic Details
Published inMasui. The Japanese journal of anesthesiology Vol. 53; no. 11; p. 1279
Main Authors Otsuka, Naomi, Igarashi, Motohiko, Shimodate, Yuuki, Nakabayashi, Kenichi, Asano, Makoto, Namiki, Akiyoshi
Format Journal Article
LanguageJapanese
Published Japan 01.11.2004
Subjects
Aged
Amyotrophic Lateral Sclerosis - complications
Anesthesia, Epidural
Anesthesia, Spinal
Emergencies
Female
Gastric Fistula - surgery
Humans
Ileus - surgery
Middle Aged
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Summary:We experienced anesthetic management of two cases of amyotrophic lateral sclerosis (ALS). Case 1. A 46-year-old woman underwent emergency operation for ileus. Abdominal muscle relaxation and analgesia were obtained by combined spinal and epidural anesthesia. To avoid prolongation of muscle relaxation, awake intubation without muscle relaxants was performed. After the operation, she awoke smoothly and was extubated without any complications. Case 2. A 65-year-old woman underwent emergency operation for gastric fistula malfunction. We performed anesthetic management only with epidural anesthesia. During and after the operation, she was in good general condition and had no pain. For the patients with ALS, prolongation of muscle relaxation and residual neuromuscular block effect may cause difficult tracheal extubation and postoperative respiratory complications. We observed carefully the condition of the patients with ALS, and were able to choose the minimum invasive anesthetic methods for each case.
ISSN:0021-4892