[Anesthetic Management of Laparoscopic Nephrectomy for a Renal Cancer Patient with Distal Myopathy of Rimmed Vacuole].

Abstract

A 56-year-old male with distal myopathy of rimmed vacuoles underwent laparoscopic nephrectomy. Anesthesia was induced with propofol, remifentanil and ketamine. Tracheal intubation using McGRATH was uneventful without using muscle relaxants. Then ultrasound-guided right thoracic paravertebral (TPVB) block was performed using 20 ml 0.75% ropivacaine with 10 ml 2% lidocaine by 3 injections of 10 ml each at T9 to T11. General anesthesia was maintained with propofol, remifentanil and ketamine monitoring bispectral index. Good surgical condition and pneumoperitoneum were maintained without using muscle relaxants. His postoperative course was smooth and uneventful, even though a small amount of fentanyl was administrated to relieve wound pain. This case suggests that McGRATH and ultrasound-guided TPVB can be one of the options to avoid using muscle relaxants in patient with neuromuscular disease.

• Authors: Junichi Saito, Satoko Noguchi, Anna Matsumoto, Kei Jinushi, Toshinori Kasai, Masato Kitayama, Kazuyoshi Hirota
• Journal: Masui. The Japanese journal of anesthesiology (Masui) Vol. 64 Issue 2 Pg. 164-7 (Feb 2015) ISSN: 0021-4892 [Print] Japan
• PMID: 26121810 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Anesthetics, Intravenous
• Drug Combinations

Topics

• Anesthesia, General
• Anesthetics, Intravenous (administration & dosage)
• Distal Myopathies (complications, pathology)
• Drug Combinations
• Humans
• Intubation, Intratracheal
• Kidney Neoplasms (complications, surgery)
• Laparoscopy (methods)
• Male
• Middle Aged
• Nephrectomy
• Vacuoles (pathology)