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[Spinal anesthesia for a patient with long-term SMON].
H Yuasa1, T Higashizawa, Y Shiokawa
1Department of Anesthesiology, Wakakusa Daiichi Hospital, Higashiosaka.
Masui. the Japanese Journal of Anesthesiology
|February 26, 1999
Summary
Subacute myelo-optico-neuropathy (SMON) patients can safely receive spinal anesthesia. Anesthesia limited below the level of neurological degeneration prevented adverse effects in a long-term SMON case.
Area of Science:
- Neurology
- Anesthesiology
Background:
- Subacute myelo-optico-neuropathy (SMON) is a neurological disorder potentially caused by clioquinol neurotoxicity.
- Long-term SMON involves neurodegeneration extending from the medulla oblongata to the T5-T6 spinal cord level.
Observation:
- An 81-year-old female with a history of SMON underwent surgery for a left intertrochanteric fracture.
- She received spinal anesthesia, with the analgesia level confirmed below T10 via pinprick testing, staying below the T5-T6 degeneration level.
- Neurological status and vital signs remained stable throughout the procedure and postoperative period.
Findings:
- Spinal anesthesia administered below the established level of neurodegeneration in long-term SMON did not exacerbate neurological deficits.
- The patient experienced no adverse neurological events post-anesthesia.
Implications:
- This case suggests that carefully managed spinal anesthesia, targeting levels below known neurological damage, is a viable option for patients with long-term SMON.
- This approach may allow surgical interventions in SMON patients who might otherwise be considered high-risk for anesthesia-related complications.