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Anaesthesia for ophthalmologic surgical procedures in a patient with advanced amyotrophic lateral sclerosis: a case report

INTRODUCTION: Anaesthesia procedures for surgical interventions in patients with amyotrophic lateral sclerosis (ALS) are not commonly found in clinical practice, and often have special considerations that must be taken into account in treatment planning. As a result, these procedures are rarely subj...

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Autores principales: Kowalik, Maciej M, Smiatacz, Tomasz, Pajuro, Robert, Skowroński, Roman, Trocha, Hanna, Nyka, Walenty, Raczyńska, Krystyna, Wujtewicz, Maria
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600792/
https://www.ncbi.nlm.nih.gov/pubmed/19021894
http://dx.doi.org/10.1186/1757-1626-1-338
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author Kowalik, Maciej M
Smiatacz, Tomasz
Pajuro, Robert
Skowroński, Roman
Trocha, Hanna
Nyka, Walenty
Raczyńska, Krystyna
Wujtewicz, Maria
author_facet Kowalik, Maciej M
Smiatacz, Tomasz
Pajuro, Robert
Skowroński, Roman
Trocha, Hanna
Nyka, Walenty
Raczyńska, Krystyna
Wujtewicz, Maria
author_sort Kowalik, Maciej M
collection PubMed
description INTRODUCTION: Anaesthesia procedures for surgical interventions in patients with amyotrophic lateral sclerosis (ALS) are not commonly found in clinical practice, and often have special considerations that must be taken into account in treatment planning. As a result, these procedures are rarely subject to publication, rendering it difficult for the anaesthesiologists to find useful and reliable information on this topic. ALS also presents a contraindication to the use of nondepolarising neuromuscular blocking drugs during general anaesthesia. CASE PRESENTATION: In the case presented here, a 52-year old, White man, the progression of the disease to tetraparesis and respiratory failure, in addition to having the patient on chronic mechanical ventilation support, provided additional challenges to the handling team. The maturation of cataracts severely impaired communication with the patient, and surgical treatment of the cataract presented the only means to save communication. Such interventions are generally performed under local anaesthesia with the advice of the attending anaesthesiologist. However, in this case the patients' announcements during the operation would be unreadable to the advising anaesthesiologist. Here, the authors share experiences from a successfully applied combination of topical and general anaesthesia for two cataract operations and a vitrectomy. This was tolerated well by the patient, and without any side-effects. CONCLUSION: The applied treatment resulted in a substantial improvement of the vision and allowed communication to be maintained with the patient.
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spelling pubmed-26007922008-12-12 Anaesthesia for ophthalmologic surgical procedures in a patient with advanced amyotrophic lateral sclerosis: a case report Kowalik, Maciej M Smiatacz, Tomasz Pajuro, Robert Skowroński, Roman Trocha, Hanna Nyka, Walenty Raczyńska, Krystyna Wujtewicz, Maria Cases J Case Report INTRODUCTION: Anaesthesia procedures for surgical interventions in patients with amyotrophic lateral sclerosis (ALS) are not commonly found in clinical practice, and often have special considerations that must be taken into account in treatment planning. As a result, these procedures are rarely subject to publication, rendering it difficult for the anaesthesiologists to find useful and reliable information on this topic. ALS also presents a contraindication to the use of nondepolarising neuromuscular blocking drugs during general anaesthesia. CASE PRESENTATION: In the case presented here, a 52-year old, White man, the progression of the disease to tetraparesis and respiratory failure, in addition to having the patient on chronic mechanical ventilation support, provided additional challenges to the handling team. The maturation of cataracts severely impaired communication with the patient, and surgical treatment of the cataract presented the only means to save communication. Such interventions are generally performed under local anaesthesia with the advice of the attending anaesthesiologist. However, in this case the patients' announcements during the operation would be unreadable to the advising anaesthesiologist. Here, the authors share experiences from a successfully applied combination of topical and general anaesthesia for two cataract operations and a vitrectomy. This was tolerated well by the patient, and without any side-effects. CONCLUSION: The applied treatment resulted in a substantial improvement of the vision and allowed communication to be maintained with the patient. BioMed Central 2008-11-20 /pmc/articles/PMC2600792/ /pubmed/19021894 http://dx.doi.org/10.1186/1757-1626-1-338 Text en Copyright © 2008 Kowalik et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kowalik, Maciej M
Smiatacz, Tomasz
Pajuro, Robert
Skowroński, Roman
Trocha, Hanna
Nyka, Walenty
Raczyńska, Krystyna
Wujtewicz, Maria
Anaesthesia for ophthalmologic surgical procedures in a patient with advanced amyotrophic lateral sclerosis: a case report
title Anaesthesia for ophthalmologic surgical procedures in a patient with advanced amyotrophic lateral sclerosis: a case report
title_full Anaesthesia for ophthalmologic surgical procedures in a patient with advanced amyotrophic lateral sclerosis: a case report
title_fullStr Anaesthesia for ophthalmologic surgical procedures in a patient with advanced amyotrophic lateral sclerosis: a case report
title_full_unstemmed Anaesthesia for ophthalmologic surgical procedures in a patient with advanced amyotrophic lateral sclerosis: a case report
title_short Anaesthesia for ophthalmologic surgical procedures in a patient with advanced amyotrophic lateral sclerosis: a case report
title_sort anaesthesia for ophthalmologic surgical procedures in a patient with advanced amyotrophic lateral sclerosis: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600792/
https://www.ncbi.nlm.nih.gov/pubmed/19021894
http://dx.doi.org/10.1186/1757-1626-1-338
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