title: [Anesthetic management of a patient with hereditary spastic paraplegia].
abstract: We experienced the anesthetic management of a 39 year-old-male with hereditary spastic paraplegia (HSP) associated with pain due to pes cavus. He underwent orthomorphia ostectomy and tenodesis. Preoperative neurological examination revealed that he had slight dementia, symptoms of the pyramidal tract, lower limb bathyhypesthesia, and neurogenic bladder in addition to spastic paraplegia, and he was diagnosed as having combined type of HSP. Spinocerebellar degeneration is often accompanied with this type of HSP. To avoid the use of muscle relaxants and narcotics, we tried to induce anesthesia with inhalation of nitrous oxide (N2O), oxygen and sevoflurane (sevo). A laryngeal mask (LM) was inserted at the expiratory concentration of sevo 3.5%. Anesthesia was maintained by N2O, oxygen and sevo (2-3%) under spontaneous respiration. The patient recovered from anesthesia after the end of surgery, and the LM was removed smoothly. The patient's respiratory condition was stable, and no problems were found in the postoperative period.
authors.affiliation: Department of Anesthesia, Shirakawa Hospital, Shirakawa 961-0092.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kunisawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahata
authors.forename: Koji
authors.initials: K
authors.lastname: Takayama
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Sengoku
authors.forename: Akihiro
authors.initials: A
authors.lastname: Suzuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki
mesh_terms: D000328:Adult; D000769:Anesthesia, Inhalation / Q000379:methods*; D018685:Anesthetics, Inhalation; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008738:Methyl Ethers; D009609:Nitrous Oxide; D010100:Oxygen; D000077149:Sevoflurane; D015419:Spastic Paraplegia, Hereditary / Q000150:complications*; D013132:Spinocerebellar Degenerations / Q000150:complications
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide; D010100:Oxygen