[Anesthetic management of a patient with Eaton-Lambert syndrome with chronic respiratory failure].
A 66-year-old male with colon cancer was scheduled for left hemicolectomy. He had a past history of respiratory failure due to chronic obstructive pulmonary disease (COPD). Anesthesia method chosen was general anesthesia with sevo-flurane combined with epidural anesthesia. Respiration was managed with assisted ventilation using laryngeal mask airway and muscle relaxation was obtained with suxamethonium chloride given intermittently. After the operation, he did not seem to have COPD because of the relation between arterial PCO2 and bicarbonate in the perioperative period. Therefore, after obtaining informed consent from this patient, we determined the relation between arterial and spinal fluid acid-base balance under acetazolamide administration. He was more sensitive to central respiratory response because his respiration increased following the decrease of spinal fluid bicarbonate. We further examined and diagnosed him as Eaton-Lambert syndrome by evoked electromyography and by Ca2+ channel antibody.
Onozawa
H
H
Department of Anesthesiology, Jikei University School of Medicine, Tokyo.
Tanaka
T
T
Kagaya
S
S
Kumagai
M
M
Asano
T
T
Tanifuji
Y
Y
D000368:Aged; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D002908:Chronic Disease; D003082:Colectomy; D003110:Colonic Neoplasms / Q000601:surgery; D006801:Humans; D015624:Lambert-Eaton Myasthenic Syndrome / Q000150:complications* / Q000175:diagnosis; D008297:Male; D012131:Respiratory Insufficiency / Q000209:etiology*