J Dent Anesth Pain Med.  2019 Aug;19(4):235-238. 10.17245/jdapm.2019.19.4.235.

Anesthetic management in corticobasal degeneration with central sleep apnea: A case report

Affiliations
  • 1Department of Dental Anesthesia, The Nippon Dental University Hospital, Tokyo, Japan. ysk.shionoya@gmail.com
  • 2Department of Dental Anesthesiology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan.

Abstract

Corticobasal degeneration (CBD) is a rare neurodegenerative disease characterized by dystonia, cognitive deficits, and an asymmetric akinetic-rigid syndrome. Little information is available regarding anesthetic management for CBD patients. Our patient was a 55-year-old man with CBD complicated by central sleep apnea (CSA). Due to the risk of perioperative breathing instability associated with anesthetic use, a laryngeal mask airway was used during anesthesia with propofol. Spontaneous respiration was stable under general anesthesia. However, respiratory depression occurred following surgery, necessitating insertion of a nasopharyngeal airway. Since no respiratory depression had occurred during maintenance of the airway using the laryngeal mask, we suspected an upper airway obstruction caused by displacement of the tongue due to residual propofol. Residual anesthetics may cause postoperative respiratory depression in patients with CBD. Therefore, continuous postoperative monitoring of SpOâ‚‚ and preparations to support postoperative ventilation are necessary.

Keyword

Corticobasal Degeneration; Laryngeal Mask Airway; Propofol; Sleep Apnea

MeSH Terms

Airway Obstruction
Anesthesia
Anesthesia, General
Anesthetics
Cognition Disorders
Dystonia
Humans
Laryngeal Masks
Middle Aged
Neurodegenerative Diseases
Propofol
Respiration
Respiratory Insufficiency
Sleep Apnea Syndromes
Sleep Apnea, Central*
Tongue
Ventilation
Anesthetics
Propofol

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