Combined general and epidural anesthesia for major abdominal surgery in a patient with Pompe disease.
We present a case of combined general anesthesia with muscle relaxant and epidural analgesia for hemicolectomy in a 56-year-old woman with Pompe disease. Progressive pulmonary function loss predisposes Pompe disease patients to an increased risk of aspiration pneumonia, atelectasis, and all pulmonary infections. Given the impaired cough resulting from abdominal muscle weakness, patients with Pompe disease who undergo abdominal major surgery are prone to great risks of postoperative pulmonary complications. In our case, to optimize the patient's pulmonary toilet during the postoperative period, epidural block was provided as well as general anesthesia. Although she had a severe scoliotic spine and a worst pulmonary function test, the attempt of epidural block provided excellent pain control and pulmonary toilet care.
Kim
Won Sung
WS
Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, 1-10 Ami-dong, Seo-gu, Busan 602-739, Korea.
Cho
Ah Reum
AR
Hong
Jung Min
JM
Kim
Eun Soo
ES
Park
Sung Chun
SC
Yoon
Ji Young
JY
Kim
Tae Kyun
TK
D000005:Abdomen / Q000601:surgery*; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D001784:Blood Gas Analysis; D001786:Blood Glucose / Q000378:metabolism; D001831:Body Temperature / Q000502:physiology; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003082:Colectomy; D003110:Colonic Neoplasms / Q000601:surgery; D004298:Dopamine / Q000627:therapeutic use; D005260:Female; D006009:Glycogen Storage Disease Type II / Q000150:complications* / Q000000981:diagnostic imaging; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D012129:Respiratory Function Tests
D001786:Blood Glucose; D002316:Cardiotonic Agents; D004298:Dopamine