Demyelinating Peripheral Polyneuropathy: Anesthetic Implications

Authors

  • Cláudia Antunes Interna de Formação Específica de Anestesiologia do Hospital Senhora da Oliveira, Guimarães, Portugal.
  • Sara Ferreira Interna de Formação Específica de Anestesiologia do Hospital Senhora da Oliveira, Guimarães, Portugal
  • Ana Coutinho Assistente especialista de Anestesiologia do Hospital Senhora da Oliveira, Guimarães, Portugal.
  • Neuza Sousa Assistente especialista de Anestesiologia do Hospital Senhora da Oliveira, Guimarães, Portugal.

DOI:

https://doi.org/10.25751/rspa.17707

Keywords:

Anesthesia, Intravenous; Anesthetics, Intravenous; Charcot-Marie-Tooth Disease; Propofol; Remifentanil

Abstract

Charcot-Marie-Tooth disease is a demyelinating peripheral polyneuropathy characterized by distal muscular weakness, motor and sensory disorders and skeletal deformities. The main challenges in the anesthetic approach in these patients are related to the adequate use of muscle relaxants and to the risk of malignant hyperthermia. 

43-year-old woman, ASA 3, proposed for lower limb varicose vein stripping surgery. History of axonal polyneuropathy with Charcot-Marie-Tooth disease panel.
She presented distal tetraparesis associated with significant motor incapacity, and dysphagia for liquids. General intravenous anesthesia with Propofol and Remifentanil was chosen, without muscle relaxant. The patient remained hemodynamically stable and the procedure was uneventfully. 

Although there are concerns with the anesthetic approach of patients with polyneuropathy, the option of general intravenous anesthesia with propofol and remifentanil was adequate and safe in this patient. 

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Published

2019-12-28

How to Cite

Antunes, C., Ferreira, S., Coutinho, A., & Sousa, N. (2019). Demyelinating Peripheral Polyneuropathy: Anesthetic Implications. Journal of the Portuguese Society of Anesthesiology, 28(4), 262–264. https://doi.org/10.25751/rspa.17707