Publication:


abstract

amyotrophic lateral sclerosis (ALS) is a degenerative disease involving motor neurons. The anesthetic problem is increased susceptibility to non-depolarizing muscle relaxants and the feasibility of spinal and epidural anesthesia. An 86-year-old man with ALS underwent colostomy to the ileus. We chose general anesthesia with propofol, remifentanil, rocuronium and sugammadex. We administered 30 mg (0.52 mg . kg-1) of rocuronium only for induction. TOF-count was 2 at the end of operation. At spontaneous neuromuscular recovery to TOF-count 3, we administered sugammadex 2.1 mg . kg-1. The patient emerged from general anesthesia smoothly, and was extubated. Post-operative course was uneventful. Our anesthetic management of ALS patient using sugammadex was successful. Further evidence is required to establish appropriate Use of sugammadex for ALS patients.

Related Articles
[Anesthetic management of laparotomy for a patient with amyotrophic lateral sclerosis: a case report].
Masui. 2008
[Anesthetic management of laparotomy for a patient with amyotrophic lateral sclerosis: a case report].
Iwanaga S, Kitamura T, Ogawa M, Yamada Y. Masui. 2008 Aug; 57(8):987-9.
[Successful use of sugammadex in a muscular dystrophy patient].
Masui. 2011
[Successful use of sugammadex in a muscular dystrophy patient].
Yamada M, Kimura T. Masui. 2011 Oct; 60(10):1205-6.
[Efficacy of sugammadex in the reversal of neuromuscular blockade induced by rocuronium in long-duration surgery: under inhaled vs. intravenous anesthesia].
Rev Esp Anestesiol Reanim. 2009
[Efficacy of sugammadex in the reversal of neuromuscular blockade induced by rocuronium in long-duration surgery: under inhaled vs. intravenous anesthesia].
Veiga-Ruiz G, Domínguez N, Orozco J, Janda M, Hofmockel R, Alvarez-Gómez JA. Rev Esp Anestesiol Reanim. 2009 Jun-Jul; 56(6):349-54.
Review Sugammadex for the reversal of muscle relaxation in general anaesthesia: a systematic review and economic assessment.
Health Technol Assess. 2010
Review Sugammadex for the reversal of muscle relaxation in general anaesthesia: a systematic review and economic assessment.
Chambers D, Paulden M, Paton F, Heirs M, Duffy S, Craig D, Hunter J, Wilson J, Sculpher M, Woolacott N. Health Technol Assess. 2010 Jul; 14(39):1-211.
Review [Pharmacology of sugammadex].
Ann Fr Anesth Reanim. 2009
Review [Pharmacology of sugammadex].
Meistelman C, Fuchs-Buder T. Ann Fr Anesth Reanim. 2009 Sep; 28 Suppl 2:S51-6.