ANESTHETIC MANAGEMENT OF A SHORT UROLOGICAL PROCEDURE IN A PATIENT WITH MULTISYSTEM ATROPHY - CEREBELLAR TYPE: A CASE REPORT

AMRUTHA BINDU  NAGELLA; VASIM AKRAM; AKSHAYA AK; RANJITHA MS; SHASHIDHAR SUBBANNA; PRABHA PARTHASARATHY

doi:10.22159/ajpcr.2023.v16i6.47054

Authors

AMRUTHA BINDU NAGELLA Department of Anesthesiology, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
VASIM AKRAM Department of Anesthesiology, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
AKSHAYA AK Department of Anesthesiology, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
RANJITHA MS Department of Anesthesiology, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
SHASHIDHAR SUBBANNA Department of Anesthesiology, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
PRABHA PARTHASARATHY Department of Anesthesiology, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i6.47054

Keywords:

Multi system atrophy, Autonomic dysfunction, Neuraxial blockade

Abstract

Multisystem atrophy cerebellar type (MSA-C) is a rare, fatal, and progressive neurological disorder characterized by features of atypical parkinsonism and autonomic dysfunction. This condition poses numerous challenges in the perioperative period to the anesthesiologist for the safe conduct of anesthesia. Here, we report a case of 65-year-old male patient with the diagnosis of MSA-C who was posted for a short urological procedure. General anesthesia is usually preferred for MSA-C patients due to the autonomic dysfunction. However, after considering the risks of general anesthesia in MSA-C, we administered a low-dose spinal anesthetic. The patient was hemodynamically throughout the surgery and the post-operative period was uneventful.

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References

Ortiz JF, Betté S, Tambo W, Tao F, Cozar JC, Isaacson S. Multiple system atrophy-cerebellar type: Clinical picture and treatment of an often-overlooked disorder. Cureus 2020;12:e10741. doi: 10.7759/ cureus.10741, PMID 33173654, PMCID PMC7645310

Wenning GK, Geser F, Krismer F, Seppi K, Duerr S, Boesch S, et al. The natural history of multiple system atrophy: A prospective European cohort study. Lancet Neurol 2013;12:264-74. doi: 10.1016/S1474- 4422(12)70327-7, PMID 23391524, PMCID PMC3581815

Jang MS, Han JH, Park SW, Kang JM, Kang WJ. General anesthesia for a patient with multiple system atrophy. Korean J Anesthesiol 2014;67(Suppl):S34-5. doi: 10.4097/kjae.2014.67.S.S34, PMID 25598898, PMCID PMC4295972

Lim YS, Kennedy NJ. Multiple system atrophy as a cause of upper airway obstruction. Anaesthesia 2007;62:1179-82. doi: 10.1111/j.1365- 2044.2007.05227.x, PMID 17924902

Agarwal S, Aggarwal R. Anesthetic considerations in a patient with multiple system atrophy-cerebellar for lower limb surgery. Saudi J Anaesth 2017;11:365-6. doi: 10.4103/sja.SJA_57_17, PMID 28757850, PMCID PMC5516512

Mustafa HI, Fessel JP, Barwise J, Shannon JR, Raj SR, Diedrich A, et al. Dysautonomia: Perioperative implications. Anesthesiology 2012;116:205-15. doi: 10.1097/ALN.0b013e31823db712, PMID 22143168, PMCID PMC3296831