Thoracic segmental spinal anesthesia for radical nephrectomy in a patient with amyotrophic lateral sclerosis—a case report
Abstract Background Amyotrophic lateral sclerosis (ALS) is a rare but fatal neurodegenerative disease of the motor neurons that causes muscle weakness, atrophy, and eventually respiratory failure and death. Anesthesia in these patients carries the risk of aspiration, altered response to muscle relax...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-05-01
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| Series: | Ain Shams Journal of Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42077-023-00326-6 |
| _version_ | 1797823022866890752 |
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| author | Prajnananda Haloi Rahul Biswas Ananta Bora |
| author_facet | Prajnananda Haloi Rahul Biswas Ananta Bora |
| author_sort | Prajnananda Haloi |
| collection | DOAJ |
| description | Abstract Background Amyotrophic lateral sclerosis (ALS) is a rare but fatal neurodegenerative disease of the motor neurons that causes muscle weakness, atrophy, and eventually respiratory failure and death. Anesthesia in these patients carries the risk of aspiration, altered response to muscle relaxants and opioids, ventilatory depression, and neurotoxicity to local anesthetics. Thoracic segmental spinal anesthesia may be a viable alternative to general anesthesia in upper abdominal surgeries in ALS patients. Case presentation A 38-year-old patient with ALS diagnosed with a left renal mass of mitotic origin was scheduled for radical nephrectomy after an evaluation. Thoracic segmental spinal anesthesia was planned for the patient. The surgery and perioperative period were uneventful, and postoperative analgesic consumption was minimal. The patient was discharged without any progress in his neurodegenerative state. Conclusions Our experience with thoracic segmental spinal anesthesia for nephrectomy in this ALS has been satisfactory. Our goals of maintaining hemodynamic stability, avoiding respiratory depression, and limiting further neurological impairment were all achieved. Further studies are needed to establish thoracic segmental spinal anesthesia as a better modality for such cases. |
| first_indexed | 2024-03-13T10:17:30Z |
| format | Article |
| id | doaj.art-873c8d1ec8a04c4988404d6eba35a182 |
| institution | Directory Open Access Journal |
| issn | 2090-925X |
| language | English |
| last_indexed | 2024-03-13T10:17:30Z |
| publishDate | 2023-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Ain Shams Journal of Anesthesiology |
| spelling | doaj.art-873c8d1ec8a04c4988404d6eba35a1822023-05-21T11:09:23ZengSpringerOpenAin Shams Journal of Anesthesiology2090-925X2023-05-011511410.1186/s42077-023-00326-6Thoracic segmental spinal anesthesia for radical nephrectomy in a patient with amyotrophic lateral sclerosis—a case reportPrajnananda Haloi0Rahul Biswas1Ananta Bora2Anaesthesiology and Critical Care, GNRC MedicalAnaesthesiology and Critical Care, GNRC MedicalAnaesthesiology and Critical Care, GNRC MedicalAbstract Background Amyotrophic lateral sclerosis (ALS) is a rare but fatal neurodegenerative disease of the motor neurons that causes muscle weakness, atrophy, and eventually respiratory failure and death. Anesthesia in these patients carries the risk of aspiration, altered response to muscle relaxants and opioids, ventilatory depression, and neurotoxicity to local anesthetics. Thoracic segmental spinal anesthesia may be a viable alternative to general anesthesia in upper abdominal surgeries in ALS patients. Case presentation A 38-year-old patient with ALS diagnosed with a left renal mass of mitotic origin was scheduled for radical nephrectomy after an evaluation. Thoracic segmental spinal anesthesia was planned for the patient. The surgery and perioperative period were uneventful, and postoperative analgesic consumption was minimal. The patient was discharged without any progress in his neurodegenerative state. Conclusions Our experience with thoracic segmental spinal anesthesia for nephrectomy in this ALS has been satisfactory. Our goals of maintaining hemodynamic stability, avoiding respiratory depression, and limiting further neurological impairment were all achieved. Further studies are needed to establish thoracic segmental spinal anesthesia as a better modality for such cases.https://doi.org/10.1186/s42077-023-00326-6Amyotrophic lateral sclerosisThoracic segmental spinal anesthesiaNephrectomyRespiratory depressionNeurodegenerative disease |
| spellingShingle | Prajnananda Haloi Rahul Biswas Ananta Bora Thoracic segmental spinal anesthesia for radical nephrectomy in a patient with amyotrophic lateral sclerosis—a case report Ain Shams Journal of Anesthesiology Amyotrophic lateral sclerosis Thoracic segmental spinal anesthesia Nephrectomy Respiratory depression Neurodegenerative disease |
| title | Thoracic segmental spinal anesthesia for radical nephrectomy in a patient with amyotrophic lateral sclerosis—a case report |
| title_full | Thoracic segmental spinal anesthesia for radical nephrectomy in a patient with amyotrophic lateral sclerosis—a case report |
| title_fullStr | Thoracic segmental spinal anesthesia for radical nephrectomy in a patient with amyotrophic lateral sclerosis—a case report |
| title_full_unstemmed | Thoracic segmental spinal anesthesia for radical nephrectomy in a patient with amyotrophic lateral sclerosis—a case report |
| title_short | Thoracic segmental spinal anesthesia for radical nephrectomy in a patient with amyotrophic lateral sclerosis—a case report |
| title_sort | thoracic segmental spinal anesthesia for radical nephrectomy in a patient with amyotrophic lateral sclerosis a case report |
| topic | Amyotrophic lateral sclerosis Thoracic segmental spinal anesthesia Nephrectomy Respiratory depression Neurodegenerative disease |
| url | https://doi.org/10.1186/s42077-023-00326-6 |
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