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Anesthetic management for surgery in a nemaline myopathy patient with difficult airway: A CARE-compliant case report

Hoon Jung1, Hyunjee Kim, See Woo Lee

  • 1Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Medicine
|November 21, 2023
PubMed
Abstract

Insights

Anesthesia management for nemaline myopathy (NM) requires careful planning due to respiratory risks. This case demonstrates successful general anesthesia induction and recovery in a high-risk NM patient, ensuring safety.

Area of Science:

  • Anesthesiology
  • Neuromuscular Disorders

Background:

  • Nemaline myopathy (NM) presents with muscle weakness and potential respiratory/cardiac compromise, increasing anesthesia risks.
  • Patients with NM may require surgical intervention, necessitating careful anesthetic planning.

Observation:

  • A 35-year-old male with NM, ACTA1 mutation, and difficult airway underwent surgery for limited mouth opening.
  • The patient had restrictive ventilatory pattern and pulmonary hypertension, posing significant anesthetic challenges.

Findings:

  • Awake fiberoptic nasal intubation was successfully performed under analgesia.
  • General anesthesia was maintained with inhalational agents and opioids, avoiding neuromuscular blockers.
  • The patient experienced uneventful recovery without complications.

Implications:

  • This case underscores the feasibility of safe anesthesia in high-risk NM patients.
  • Careful preoperative assessment and tailored anesthetic techniques are crucial for managing NM patients.
  • Highlights the importance of avoiding neuromuscular blocking agents in NM patients.

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