Anesthetic Management for Inclusion Body Myositis in Coronary Artery Bypass Graft Surgery

Kim, Uoo

doi:10.1155/2020/6679156

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…Some suggested getting a baseline pulmonary status with pulmonary function testing. 6,9 However, given that a preoperative PFT is not predictive of postoperative pulmonary complications and of the need for postoperative ventilatory support, 10,11 the team decided not to delay the surgery to obtain a pulmonary function test. In addition, PFT is more useful in monitoring treatment response.…”

Section: Discussionmentioning

confidence: 99%

“…2 There are very few existing literatures on the anesthetic management of a patient with inclusion body myositis. 2,[4][5][6][7][8] This case report highlights how risk reduction and prevention of adverse events guaranteed patient safety in a patient with IBM who received general anesthesia for esophagoscopy, cricopharyngeal Botox injection, and percutaneous endoscopic gastrostomy.…”

Section: Introductionmentioning

confidence: 99%

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Anesthesia Spearheading Perioperative Safety Efforts in a Patient with Inclusion Body Myositis: A Case Report

Aspi, MD,

Arancon, MD, MBA

2024

Acta Med Philipp

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Anesthesiologists have been at the forefront of initiatives addressing perioperative patient safety. As anesthesia has no direct therapeutic benefit, its risk must be minimized. At times the surgery is simple but the patient’s condition complicates anesthetic management, increasing the risk for complications. This report describes the anesthetic management of an adult patient diagnosed with inclusion body myositis (IBM), a rare inflammatory degenerative myopathy, who initially presented with decreased motor function in both lower and upper extremities causing him to be bedbound for two years. Due to the progression of his disease, he eventually developed dysphagia, hence he was scheduled for esophagoscopy, cricopharyngeal Botox injection, and percutaneous endoscopic gastrostomy. As patients with IBM are at risk for exaggerated sensitivity to neuromuscular blockers and respiratory compromise, anesthesia was at the helm of a multidisciplinary team approach. The perioperative management centered on preoperative optimization, prevention of aspiration, avoidance of anesthetics that may trigger malignant hyperthermia, and prevention of postoperative pulmonary complication. The hospital course was uncomplicated and the patient was discharged well after one day. This report emphasizes how improvements in resources, technology, and healthcare delivery, especially in anesthesia, help prevent perioperative adverse events.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anesthesia Spearheading Perioperative Safety Efforts in a Patient with Inclusion Body Myositis: A Case Report

Aspi, MD,

Arancon, MD, MBA

2024

Acta Med Philipp

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Perioperative Management of Paraneoplastic Necrotizing Myopathy in Thyroidectomy: A Case Report

Wong

2024

Cureus

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Perioperative management of patients with myopathies can be challenging due to the increased risk of malignant hyperthermia (MH) and anesthesia-induced rhabdomyolysis (AIR). However, currently, there is no evidence regarding the optimal anesthetic management for paraneoplastic necrotizing myopathy (PNM) (total intravenous anesthetic vs. volatile anesthetics). Here, I report a case where anesthesia was administered safely using volatile anesthetics. A 63-year-old female presented with PNM associated with papillary thyroid carcinoma, necessitating urgent thyroidectomy. The patient, previously diagnosed with anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) antibody-associated myopathy, exhibited progressive weakness and dysphagia, prompting suspicion of PNM. The patient's compromised respiratory status, attributed to tracheal compression by a large goiter, necessitated an urgent thyroidectomy. Anesthetic management considerations included the potential effect of HMGCR-M on respiratory muscles and the need for careful planning to mitigate postoperative complications. The patient underwent total thyroidectomy, left central compartment clearance, and tracheostomy. The surgery proceeded uneventfully, with meticulous monitoring and adjustment of anesthetic agents to maintain hemodynamic stability. Postoperatively, the patient recovered well, demonstrating complete resolution of neurological symptoms during a three-month follow-up. The case underscores the importance of recognizing paraneoplastic syndromes in the context of thyroid surgery and highlights potential challenges faced by anesthesiologists. Despite the lack of established safety data for anesthetic drugs in HMGCR-M necrotizing myopathy, the case demonstrates the successful use of sevoflurane and rocuronium.

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Anesthetic Management for Inclusion Body Myositis in Coronary Artery Bypass Graft Surgery

Cited by 2 publications

References 11 publications

Anesthesia Spearheading Perioperative Safety Efforts in a Patient with Inclusion Body Myositis: A Case Report

Anesthesia Spearheading Perioperative Safety Efforts in a Patient with Inclusion Body Myositis: A Case Report

Perioperative Management of Paraneoplastic Necrotizing Myopathy in Thyroidectomy: A Case Report

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