[Anesthesia for a patient with stiff-person syndrome].
Stiff-person syndrome is a rare disease characterized by muscle rigidity and painful spasms in the axial and limb muscles. The authors reported here a case of an axilally lymphadenectomy in a 46-year-old woman with stiff-person syndrome. With train of four ratio (TOFR) monitoring at the ulnar nerve, general anesthesia was induced and maintained with fentanyl, vecuronium and propofol with target controlled infusion. A TOFR, BIS monitor and invasive arterial pressure monitoring were employed. During the operation, there was no muscle rigidity and spasm. Ten minutes after the operation, she was fully awake and train of four ratio recovered to 95%, and extubated uneventfully. We chose propofol, because of previous reports about prolonged hypotonicity by interaction of baclofen and isoflurane. Preoperative good symptom control, choice of total intravenous anesthesia (TIVA), and application of the electrical nerve stimulator prevented postoperative hypotonia and resulted in safe anesthetic management.
Aoki
Yuta
Y
Department of Anesthesiology, Faculty of Medicine, University of Toyama, Toyama 930-0194.
Shakunaga
Kiyoshi
K
Asahi
Takehisa
T
Sasaki
Rika
R
Murahana
Junichi
J
Hatakeyama
Noboru
N
Yamazaki
Mitsuaki
M
D000771:Anesthesia, Intravenous; D001365:Axilla; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009123:Muscle Hypotonia / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D015742:Propofol; D016750:Stiff-Person Syndrome
D015742:Propofol