Korean J Anesthesiol.  2010 Nov;59(5):359-362. 10.4097/kjae.2010.59.5.359.

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

• Lee KH
• Park JS
• Lee SI
• Kim JY
• Kim KT
• Choi WJ
• Kim JW

• KMID: 2239768
• DOI: http://doi.org/10.4097/kjae.2010.59.5.359

Abstract

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.

Keyword

Emergency laparotomy; Multiple sclerosis; Sevoflurane

MeSH Terms

Adult
Androstanols
Anesthesia
Anesthesia, General
Appendicitis
Emergencies
Heparin
Humans
Intubation
Laparotomy
Male
Methyl Ethers
Multiple Sclerosis
Muscle Relaxation
Nitrous Oxide
Paraplegia
Piperidines
Postoperative Period
Propofol
Stress, Psychological
Urinary Incontinence
Venous Thrombosis
Androstanols
Heparin
Methyl Ethers
Nitrous Oxide
Piperidines
Propofol