Multiple anesthetics for a patient with stiff-person syndrome

Cassavaugh, Jessica; Oravitz, Todd M.

doi:10.1016/j.jclinane.2016.02.003

Cited by 14 publications

(9 citation statements)

References 8 publications

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“…depolarising and non-depolarising neuromuscular blocking agents on separate procedures with TOF monitoring [30]. The patient did not experience any postoperative complications.…”

Section: Journal Of Anesthesia and Intensive Care Medicinementioning

confidence: 81%

Anaesthetic Recommendations for Stiff Person Syndrome

Chan¹

2017

JAICM

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Background: Stiff person syndrome (SPS) is a neurological condition with serious implications during anaesthesia if overlooked.Objective: Our purpose was to highlight the issues encountered during anaesthesia in patients with SPS and to evaluate the most appropriate anaesthetic management during surgery.Methods: A structured search was performed throughout various databases such as Ovid medline, Pubmed, Embase and Cochrane Collaboration for articles published from 1950s and after. The search included only humans and those who underwent procedures with anaesthesia.Results: Only 13 of such case studies were found due to the rarity of the condition. Amongst these 13 patients, most were in the middle to elderly aged groups and they underwent different procedures. Their response to different drugs used for induction, neuromuscular blockade or maintenance of anaesthesia also varied with some leading to life-threatening complications especially due to postoperative hypotonia. Route of anaesthesia also had a role in changing the outcomes. Conclusion:SPS is challenging to manage and the use of drugs like midazolam, propofol, rocuronium is recommended to improve patient outcomes. Volatile agents are safe if their doses are kept to a minimum with bispectral index monitoring. Alternative routes of anaesthesia may be better but this is not always feasible.

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“…depolarising and non-depolarising neuromuscular blocking agents on separate procedures with TOF monitoring [30]. The patient did not experience any postoperative complications.…”

Section: Journal Of Anesthesia and Intensive Care Medicinementioning

confidence: 81%

Anaesthetic Recommendations for Stiff Person Syndrome

Chan¹

2017

JAICM

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“…[10][11][12] since then, many more reports have demonstrated safe use of various anesthetic agents and techniques in SPS patients. Use of volatile anesthetics, muscle relaxants, regional anesthetics, and total intravenous anesthesia (TIVA) with propofol have all been described in the literature for SPS patients without complication [13][14][15][16][17][18]. Our patient received sevoflurane, rocuronium, and sugammadex along with judicious amounts of benzodiazepine, opioid and dexmedetomidine without postoperative complications.…”

Section: Discussionmentioning

confidence: 95%

Anesthetic management of a patient with Stiff-Person Syndrome and endometrial cancer for robotic surgery: A case report

Yeoh

Lee

Tollinche

2020

IJCCR

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Stiff-person syndrome (SPS) is a rare disorder of the nervous system, characterized by muscle stiffness, rigidity, and painful spasms involving truncal and limb musculature that may severely limit mobility.Our case documents a 53-year-old patient with SPS and endometrial cancer who was positive for anti-GAD and paraneoplastic antibodies, who presented to our institution for robotic surgery. These patients are at high risk for prolonged hypotonia and mechanical ventilation. Our patient underwent general anesthesia without complications despite multiple comorbidities.

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“…Awake fiberoptic intubation has been considered as a plausible option for endotracheal intubation in such patients 15. However, this option is not feasible when SPS is accompanied by disorders such as anti-NMDAR encephalitis that result in decreased consciousness and/or lack of cooperation.…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic management of a patient with a unique combination of anti-N-methyl-D-aspartate receptor encephalitis and stiff-person syndrome

et al. 2018

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Stiff-person syndrome (SPS) and anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis are rare paraneoplastic syndromes caused by antibodies that target the central nervous system. Here, we describe a 26-year-old woman who presented with psychosis, amnesia, rigidity and fever. After extensive diagnostic and laboratory workup, she was diagnosed with an ovarian teratoma which was causing the symptoms of anti-NMDAR encephalitis and SPS. The patient was successfully treated with laparoscopic removal of the ovarian tumour under general anaesthesia. She was placed on immunosuppressant medications preoperatively and postoperatively, and her symptoms gradually resolved. Although there are case reports regarding the anaesthetic management of SPS and anti-NMDAR encephalitis, our study is the first report of a patient afflicted with both conditions.

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Multiple anesthetics for a patient with stiff-person syndrome

Cited by 14 publications

References 8 publications

Anaesthetic Recommendations for Stiff Person Syndrome

Anaesthetic Recommendations for Stiff Person Syndrome

Anesthetic management of a patient with Stiff-Person Syndrome and endometrial cancer for robotic surgery: A case report

Anaesthetic management of a patient with a unique combination of anti-N-methyl-D-aspartate receptor encephalitis and stiff-person syndrome

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