Leprosy, Ancient Disease and Modern Anaesthetic Considerations

Mottaghi, Kamran; Safari, Fatemeh; Nashibi, Masoud; Sezari, Parisa

doi:10.5152/tjar.2020.54782

Cited by 1 publication

(1 citation statement)

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“…Altered baroreflex dysfunction and autonomic nervous function manifest as orthostatic hypotension and postprandial hypotension and can even lead to impaired myocardial contractility, hyper-reactive heart rate, and sudden cardiac death [ 5 ]. ST and T-wave changes, bundle branch block, extrasystoles, prolonged QT intervals, and arrhythmias are also noted [ 6 ]. Advanced cases might have hepatic and renal involvement, impairing metabolism and excretion of the drugs administered during anesthesia [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Steroid Premedication Might Protect From Postoperative Erythema Nodosum Leprosum in Leprosy: A Case Report

Hembrom,

Ahmed,

Karim

et al. 2024

Cureus

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Leprosy is known for its diverse pathophysiologic involvement and resulting multisystemic manifestation and morbidities. Despite global efforts to eliminate this public health illness, it is still prevalent in some Asian and European countries. Perioperative management of a leprosy patient is challenging owing to the indirect and direct involvement of the airway, respiratory, and cardiac systems; treatment-related sideeffects involving the hepato-renal systems affecting the anesthesia techniques and drugs pharmacokinetic and pharmacodynamics. While anaesthesiologists are aware of such happenings and often tailor the anesthesia management for the concerning issues, immunological aspects of the disease and drug-related adverse events are less enquired about, such as type-2 lepra reaction, i.e., erythema nodosum leprosum (ENL), etc. Further, data on perioperative ENL management and prevention are still being determined. We report one case of a 52-year-old female who underwent gynecology surgery and developed ENL on the third postoperative day, which was managed using Steroids. Unfortunately, the patient had a surgical site infection, which required another surgery within the month, while the patient was still under the steroid successfully without any adverse events. Although a single case cannot provide causation or association, the case is presented to highlight the probable preventive action of steroids on the occurrence of postoperative ENL, where surgical stress is considered a risk factor.

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Section: Discussionmentioning

confidence: 99%