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Multimodal Anesthesia-Analgesia for Patients with Huntington's Disease: A Case Series

Georgios Papastratigakis1, Maria Christofaki2, Alexandra Papaioannou3

  • 1Department of Anesthesiology, University Hospital of Heraklion, Heraklion, Crete, Greece. papastratigakisg@gmail.com.

Acta Medica Academica
|February 12, 2025
PubMed

Insights

Modern anesthetic strategies effectively manage Huntington's disease (HD) patients undergoing surgery. Opioid-sparing multimodal approaches ensure safe anesthesia, even when locoregional techniques are not feasible, leading to uncomplicated recoveries.

Area of Science:

  • Anesthesiology
  • Neurology
  • Genetics

Background:

  • Huntington's disease (HD) presents unique anesthetic challenges due to its progressive neurodegenerative nature.
  • Managing patients with HD requires careful consideration of anesthetic techniques to mitigate risks associated with the disease and its symptoms, such as chorea.

Purpose of the Study:

  • To demonstrate the successful anesthetic management of patients with Huntington's disease (HD) undergoing major surgery.
  • To highlight the efficacy of modern, opioid-sparing, multimodal anesthetic strategies in this patient population.

Main Methods:

  • Presentation of two case studies involving patients with Huntington's disease receiving general anesthesia for major surgical procedures.
  • Utilized opioid-sparing, multimodal anesthetic-analgesic strategies, including dexmedetomidine infusion, when locoregional techniques were not feasible due to patient factors (chorea) or resource limitations.
  • Managed patients with concurrent alcohol use disorder (AUD) and HD.

Main Results:

  • Both patients with Huntington's disease experienced successful anesthetic management and uncomplicated postoperative courses.
  • A brief amelioration of choreic movements was observed postoperatively in both patients following the anesthetic intervention.
  • This study reports the first case of a patient with Huntington's disease and concurrent AUD undergoing general anesthesia with these modern strategies.

Conclusions:

  • Modern, opioid-sparing, multimodal anesthetic strategies are safe and effective for managing patients with Huntington's disease undergoing major surgery.
  • These approaches provide a viable alternative to locoregional techniques, ensuring patient safety and minimizing opioid-related adverse effects.
  • Dexmedetomidine may offer benefits in managing chorea symptoms perioperatively in HD patients.
Abstract

Keywords:
Alcohol Use DisorderChoreaDexmedetomidineHuntington DiseaseNon-opioid Analgesic

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