Difference between revisions of "Amyotrophic lateral sclerosis"
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* Non-depolarizing neuromuscular blockers may be prolonged | * Non-depolarizing neuromuscular blockers may be prolonged | ||
* Take caution with regional anesthesia, although it is not contraindicated | * Take caution with regional anesthesia, although it is not contraindicated | ||
*Neuraxial:<ref>{{Cite journal|last=Panchamia|first=Jason K|last2=Gurrieri|first2=Carmelina|last3=Amundson|first3=Adam W|date=2020-07|title=<p>Spinal Anesthesia for Amyotrophic Lateral Sclerosis Patient Undergoing Lower Extremity Orthopedic Surgery: An Overview of the Anesthetic Considerations</p>|url=http://dx.doi.org/10.2147/imcrj.s256716|journal=International Medical Case Reports Journal|volume=Volume 13|pages=249–254|doi=10.2147/imcrj.s256716|issn=1179-142X}}</ref> | |||
**Benefits: decreased chance of prolonged intubation secondary to bulbar weakness | |||
**Risks: Increased risk of worsening neurologic condition postoperatively, risk of sympathectomy resulting in vasodilation and hypotension, high spinal presents risk of bradycardia, worsening hypotension, cardiovascular collapse. | |||
*General anesthesia: Increased risk of prolonged intubation secondary to bulbar weakness | |||
=== Postoperative management<!-- Describe how this comorbidity may influence postoperative management. --> === | === Postoperative management<!-- Describe how this comorbidity may influence postoperative management. --> === | ||
Latest revision as of 04:51, 14 June 2023
Amyotrophic lateral sclerosis
| Other names | ALS |
|---|---|
| Anesthetic relevance |
Low |
| Anesthetic management |
- No specific anesthetic drugs are best for this disease - Succinylcholine may cause hyperkalemia due to LMN disease - Non-depolarizing NMDs may be prolonged - Bulbar involvement may increase aspiration risk |
| Specialty |
Neurology |
| Signs and symptoms | |
| Diagnosis |
Based upon clinical signs and symptoms |
| Treatment | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Provide a brief summary of this comorbidity here.
Anesthetic implications
Preoperative optimization
Intraoperative management
- No ideal anesthesia for this condition
- Take caution with succinylcholine administration as the LMN disease may incite hyperkalemia after administration
- Non-depolarizing neuromuscular blockers may be prolonged
- Take caution with regional anesthesia, although it is not contraindicated
- Neuraxial:[1]
- Benefits: decreased chance of prolonged intubation secondary to bulbar weakness
- Risks: Increased risk of worsening neurologic condition postoperatively, risk of sympathectomy resulting in vasodilation and hypotension, high spinal presents risk of bradycardia, worsening hypotension, cardiovascular collapse.
- General anesthesia: Increased risk of prolonged intubation secondary to bulbar weakness
Postoperative management
Related surgical procedures
Pathophysiology
- Progressive upper and lower motor neuron degeneration
Signs and symptoms
- Skeletal muscle weakness
- Atrophy of thenar eminences
Diagnosis
Treatment
Medication
Surgery
Prognosis
Epidemiology
Affects men between the ages of 40-60
References
- ↑ Panchamia, Jason K; Gurrieri, Carmelina; Amundson, Adam W (2020-07). "<p>Spinal Anesthesia for Amyotrophic Lateral Sclerosis Patient Undergoing Lower Extremity Orthopedic Surgery: An Overview of the Anesthetic Considerations</p>". International Medical Case Reports Journal. Volume 13: 249–254. doi:10.2147/imcrj.s256716. ISSN 1179-142X. Check date values in:
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Top contributors: Nirav Kamdar and Olivia Sutton