Anesthetic management of a patient with stiff person syndrome.
We describe the successful anesthetic management of a patient with stiff-person syndrome (SPS) undergoing a right inguinal hernia repair, using a somatic paravertebral block supplemented with conscious sedation. We also present the implications of general anesthesia in patients with SPS. The use of regional anesthetic techniques in patients with SPS has the advantage of avoiding exposure to muscle relaxants. The use of general anesthesia in patients with SPS carries the risk of postoperative hypotonia due to enhancement of gamma-aminobutyric acid action on synaptic transmission by drugs that have a gamma-aminobutyric acid agonistic action.
Elkassabany
Nabil
N
Department of General Anesthesiology and Critical Care Medicine, The Cleveland Clinic Foundation, OH 44195, USA.
Tetzlaff
John E
JE
Argalious
Maged
M
D000759:Adjuvants, Anesthesia / Q000494:pharmacology*; D000368:Aged; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D000779:Anesthetics, Local / Q000494:pharmacology*; D002045:Bupivacaine / Q000494:pharmacology; D005283:Fentanyl / Q000494:pharmacology; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D008297:Male; D008874:Midazolam / Q000494:pharmacology; D015742:Propofol / Q000494:pharmacology; D016750:Stiff-Person Syndrome / Q000188:drug therapy*
D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008874:Midazolam; D005283:Fentanyl; D002045:Bupivacaine; D015742:Propofol