title: Total intravenous anesthesia for aortic aneurysm replacement surgery in a patient with limb-girdle dystrophy.
abstract: We report the anesthetic management with total intravenous anesthesia of a 61-year-old male diagnosed with limb-girdle muscular dystrophy admitted for replacement of ascending aorta due to an aortic aneurysm. Limb-girdle muscular dystrophy belongs to a genetically heterogeneous group of muscular dystrophies involving shoulder and hip girdles. Although the risk of malignant hyperthermia does not seem to be increased in these patients compared with the general population, the exposure to inhaled anesthetics and succinylcholine should probably be avoided because these patients have a predisposition to hyperkalemia and rhabdomyolysis. We chose to use total intravenous anesthesia with propofol, remifentanil and muscle relaxants to reduce oxygen consumption, and later to reduce the doses of propofol and remifentanil. The combination of a carefully planned anesthetic strategy, anesthetic depth, and neuromuscular blockade monitoring is explained.
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo (Complejo Hospitalario Universitario de Vigo), Vigo, Spain. Electronic address: lopez.alexo@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: López Álvarez
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo (Complejo Hospitalario Universitario de Vigo), Vigo, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Román Fernández
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo (Complejo Hospitalario Universitario de Vigo), Vigo, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Vilanova Vázquez
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo (Complejo Hospitalario Universitario de Vigo), Vigo, Spain.
authors.forename: M C
authors.initials: MC
authors.lastname: Corujeira Rivera
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo (Complejo Hospitalario Universitario de Vigo), Vigo, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Areán González
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo (Complejo Hospitalario Universitario de Vigo), Vigo, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Valiño Hortas
mesh_terms: D000732:Androstanols / Q000008:administration & dosage; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D000075202:Contraindications; D004198:Disease Susceptibility; D006801:Humans; D006947:Hyperkalemia / Q000517:prevention & control; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D049288:Muscular Dystrophies, Limb-Girdle / Q000150:complications*; D061886:Neuromuscular Monitoring; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D010101:Oxygen Consumption; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D000077208:Remifentanil; D012132:Respiratory Muscles / Q000503:physiopathology; D012206:Rhabdomyolysis / Q000517:prevention & control; D000077123:Rocuronium; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000008:administration & dosage
chemical_list: D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077208:Remifentanil; D000077123:Rocuronium; D015742:Propofol
keywords: Anestesia total intravenosa; Aortic aneurysm repair surgery; Ascending aorta replacement surgery; Cirugía de sustitución de aorta ascendente; Distrofia muscular de cinturas; Limb-girdle muscle dystrophy; Reparación de aneurisma aórtico; Total intravenous anesthesia