SciELO - Scientific Electronic Library Online

vol.59 issue2Patient perception of the utility of the Preanesthetic Clinics in a caribbean developing countryAnaphylaxis during renal transplantation of live donor graft in a child with latex allergy: case report author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Revista Brasileira de Anestesiologia

Print version ISSN 0034-7094On-line version ISSN 1806-907X


HOBAIKA, Adriano Bechara de Souza  and  NEVES, Bárbara Silva. Combined spinal-epidural block in a patient with amyotrophic lateral sclerosis: case report. Rev. Bras. Anestesiol. [online]. 2009, vol.59, n.2, pp.206-209. ISSN 0034-7094.

BACKGROUND AND OBJECTIVES: Amyotrophic lateral sclerosis starts between the fifth and sixth decades of life, causing degeneration and death of upper and lower motor neurons. When the muscles responsible for ventilation are affected, the patient dies of respiratory failure within a few years. CASE REPORT: This is a 63 years old female with amyotrophic lateral sclerosis who underwent surgical treatment of a transtrochanteric fracture of the femur. The patient presented weakness of upper and lower limbs and dysarthria, and she was awake and oriented. Respiratory function: ineffective cough, decreased strength of the intercostal muscles and diaphragm, and reduction of the breath sounds in both lung bases. Initially, the L3/L4 epidural space was punctured and a silicon catheter was introduced to 5 cm. This was followed by a spinal puncture in the L4/L5 space and the administration of 7.5 mg of hyperbaric bupivacaine. This was followed by the administration of 37 mg of 0.37% ropivacaine through the epidural catheter for a sensitive blockade up to T10. The procedure evolved without complications and the patient was discharged from the hospital after three days. CONCLUSIONS: The evidence has demonstrated that neuroaxis blocks can be safely performed in patients with amyotrophic lateral sclerosis since it avoids manipulation of the airways and respiratory complications.

Keywords : ANESTHETIC TECHNIQUES, Regional [combined epidural-subarachnoid]; DISEASES, Muscular [amyotrophic lateral sclerosis].

        · abstract in Portuguese | Spanish     · text in English | Portuguese     · English ( pdf epdf ) | Portuguese ( pdf epdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License