Case Report of a Patient With Idiopathic Hypersomnia and a Family History of Malignant Hyperthermia Undergoing General Anesthesia: An Overview of the Anesthetic Considerations.
The pathophysiologic underpinnings of idiopathic hypersomnia and its interactions with anesthetic medications remain poorly understood. There is a scarcity of literature describing this patient population in the surgical setting. This case report outlines the anesthetic considerations and management plan for a 55-year-old female patient with a known history of idiopathic hypersomnia undergoing an elective shoulder arthroscopy in the ambulatory setting. In addition, this case offers a unique set of considerations and conflicts related to the patient having a family history of malignant hyperthermia. A combined technique of general and regional anesthesia was used. Anesthesia was maintained with total intravenous anesthesia via the use of propofol and remifentanil. The depth of anesthesia was monitored with entropy. There were no perioperative complications.
From the *Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; †Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; ‡Toronto Sleep and Pulmonary Centre, Toronto, Ontario, Canada; and §Women's College Hospital, Toronto, Ontario, Canada.
Sena
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Aflaki
Sally
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Rami A
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Kamel
Frances
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Chung
Mandeep
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Singh
D000556:Ambulatory Surgical Procedures; D000765:Anesthesia, Conduction / Q000009:adverse effects; D000768:Anesthesia, General / Q000009:adverse effects; D001182:Arthroscopy; D005260:Female; D020022:Genetic Predisposition to Disease; D040941:Heredity; D006801:Humans; D020177:Idiopathic Hypersomnia / Q000150:complications* / Q000175:diagnosis; D008305:Malignant Hyperthermia / Q000175:diagnosis / Q000235:genetics*; D008875:Middle Aged; D012307:Risk Factors; D012785:Shoulder Joint / Q000601:surgery; D016896:Treatment Outcome