title: Sevoflurane is safe for anesthetic management in patients with multiple sclerosis.
abstract: We report a safe anesthetic management of patients with multiple sclerosis (MS) using sevoflurane. A 34-yr-old female patient with a 2-yr history of MS was scheduled for gynecological surgery. Anesthesia was induced with propofol and fentanyl and maintained with sevoflurane, nitrous oxide, and fentanyl. Vecuronium was used for tracheal intubation. The patient showed rapid emergence from anesthesia. Exacerbation of symptoms of MS was negative according to the neurologic assessment at that time. Postoperative pain was managed mainly with continuous venous infusion of fentanyl instead of neural block with local anesthetics. Transient fever due to subcutaneous infection of the surgical site was observed and topical drainage was required. Eventually, postoperative exacerbation of symptoms of MS compared with preoperative status did not appear. In conclusion, sevoflurane does not induce exacerbation of symptoms and facilitates early postoperative neurologic assessment, therefore, it is one of ideal anesthetics for MS patients.
authors.affiliation: Department of Anesthesiology, Nara Medical University, Kashihara Nara, Japan. seninoue@nmu-gw.naramed-u.ac.jp
authors.forename: Satoki
authors.initials: S
authors.lastname: Inoue
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Furuya
mesh_terms: D000328:Adult; D000368:Aged; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane