Anesthetic management of the emergency laparotomy for a patient with multiple sclerosis -A case report

• Published in: Korean journal of anesthesiology Vol. 59; no. 5; pp. 359 - 362
• Main Authors: Lee, Ki Hwa, Park, Jang Su, Lee, Sang Il, Kim, Ji Yeon, Kim, Kyeong Tae, Choi, Won Ju, Kim, Jeong Won
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Anesthesiologists 01.11.2010; Korean Society of Anesthesiologists; 대한마취통증의학회
• Subjects: Case Report; emergency laparotomy; multiple sclerosis; sevoflurane; 마취과학; Emergency laparotomy; Sevoflurane; Multiple sclerosis
• ISSN: 2005-6419; 2005-7563; 2005-7563
• DOI: 10.4097/kjae.2010.59.5.359

A 33-year-old male patient with multiple sclerosis (MS) received an emergency laparotomy because of perforated appendicitis. He had been suffering from MS for 2 years and the symptoms of MS were paraplegia and urinary incontinence. Anesthesia was induced with propofol and remifentanil and maintained with nitrous oxide, sevoflurane and remifentanil. Rocuronium was used for tracheal intubation. Train of four ratio and bispectral index scale were also monitored for adequate muscle relaxation and anesthetic depth. The patient emerged from general anesthesia smoothly and was extubated without any complication. Postoperative exacerbation of MS symptoms did not appear. However, he was rehospitalized because deep vein thrombosis (DVT) occurred after discharge and he received heparinization immediately. Eventually, he was discharged after a full recovery from DVT. We report a safe anesthetic management of the patient with MS, with the use of sevoflurane and with no the aggravation of MS during postoperative period.