An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report | ||||
| Ain-Shams Journal of Anesthesiology | ||||
| Volume 15, Issue 1, January 2023 PDF (887.42 K) | ||||
| DOI: 10.1186/s42077-023-00317-7 | ||||
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| Authors | ||||
Souvik Mukherjee   ; Vaishali Waindeskar; Kiran Molli; Akhil Kuttan Koovakattil
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| Abstract | ||||
| Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecystectomy is described. Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. However, neurologically asymptomatic patients with good treatment compliance may also show an unusual delay in recovery from neuraxial anesthesia. | ||||
| Keywords | ||||
| Case Report; Lambert-Eaton myasthenic syndrome; Neuromuscular blocking agents; Neuromuscular monitoring; Spinal anesthesia | ||||
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