Anesthetic management of the emergency laparotomy for a patient with multiple sclerosis: A case report.
10.4097/kjae.2010.59.5.359
- Author:
Ki Hwa LEE
1
;
Jang Su PARK
;
Sang Il LEE
;
Ji Yeon KIM
;
Kyeong Tae KIM
;
Won Ju CHOI
;
Jeong Won KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University, Goyang, Korea. jangpark@ilsanpaik.ac.kr
- Publication Type:Case Report
- Keywords:
Emergency laparotomy;
Multiple sclerosis;
Sevoflurane
- MeSH:
Adult;
Androstanols;
Anesthesia;
Anesthesia, General;
Appendicitis;
Emergencies;
Heparin;
Humans;
Intubation;
Laparotomy;
Male;
Methyl Ethers;
Multiple Sclerosis;
Muscle Relaxation;
Nitrous Oxide;
Paraplegia;
Piperidines;
Postoperative Period;
Propofol;
Stress, Psychological;
Urinary Incontinence;
Venous Thrombosis
- From:Korean Journal of Anesthesiology
2010;59(5):359-362
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 33-year-old male patient with multiple sclerosis (MS) received an emergency laparotomy because of perforated appendicitis. He had been suffering from MS for 2 years and the symptoms of MS were paraplegia and urinary incontinence. Anesthesia was induced with propofol and remifentanil and maintained with nitrous oxide, sevoflurane and remifentanil. Rocuronium was used for tracheal intubation. Train of four ratio and bispectral index scale were also monitored for adequate muscle relaxation and anesthetic depth. The patient emerged from general anesthesia smoothly and was extubated without any complication. Postoperative exacerbation of MS symptoms did not appear. However, he was rehospitalized because deep vein thrombosis (DVT) occurred after discharge and he received heparinization immediately. Eventually, he was discharged after a full recovery from DVT. We report a safe anesthetic management of the patient with MS, with the use of sevoflurane and with no the aggravation of MS during postoperative period.
