title: [Use of sugammadex in a patient with amyotrophic lateral sclerosis].
abstract: Amyotrophic lateral sclerosis (ALS) is a degenerative disease involving motor neurons. The anesthetic problem is increased susceptibility to non-depolarizing muscle relaxants and the feasibility of spinal and epidural anesthesia. An 86-year-old man with ALS underwent colostomy to the ileus. We chose general anesthesia with propofol, remifentanil, rocuronium and sugammadex. We administered 30 mg (0.52 mg . kg-1) of rocuronium only for induction. TOF-count was 2 at the end of operation. At spontaneous neuromuscular recovery to TOF-count 3, we administered sugammadex 2.1 mg . kg-1. The patient emerged from general anesthesia smoothly, and was extubated. Post-operative course was uneventful. Our anesthetic management of ALS patient using sugammadex was successful. Further evidence is required to establish appropriate use of sugammadex for ALS patients.
authors.affiliation: Department of Anesthesia, Hiroshima City Hospital, Hirosima 730-8518.
authors.forename: Mayuko
authors.initials: M
authors.lastname: Wachi
authors.forename: Kenji
authors.initials: K
authors.lastname: Uehara
authors.forename: Waso
authors.initials: W
authors.lastname: Fujinaka
authors.forename: Makoto
authors.initials: M
authors.lastname: Takatori
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tada
mesh_terms: D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis; D000732:Androstanols; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D003125:Colostomy; D006801:Humans; D045823:Ileus / Q000601:surgery; D007430:Intraoperative Care; D008297:Male; D009467:Neuromuscular Depolarizing Agents; D000077123:Rocuronium; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000008:administration & dosage*
chemical_list: D000732:Androstanols; D009467:Neuromuscular Depolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium