Summary
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.
Combined Spinal-Epidural Block in a Patient with Amyotrophic Lateral Sclerosis. Case Report
 
  Key Words
 
 
  
   ANESTHETIC TECHNIQUES, Regional: combined epidural-subarachnoid
  
 
 
  
   DISEASES, Muscular: amyotrophic lateral sclerosis
  
 
Summary
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 <dis>dysarthria</dis>, 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.
Summary
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.
Summary
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.