Anesthetic Considerations for Ivor-Lewis Esophagectomy in a Patient With Hereditary Spastic Paraplegia: A Case Report

A&A Practice
Phillip F YangJohnny Petrovski

Abstract

Hereditary spastic paraplegia (HSP), also known as familial spastic paraparesis or Strümpell-Lorrain disease, is a rare group of inherited disorders characterized by progressive spastic weakness in the lower limbs due to axonal degeneration of the corticospinal tracts. We describe the anesthetic management of a 52-year-old man with HSP who underwent an Ivor-Lewis esophagectomy for esophageal adenocarcinoma. This is the first report in the literature describing the anesthetic management of a patient with HSP successfully undergoing complex thoracoabdominal surgery. Key to the provision of postoperative analgesia was the intraoperative placement of catheters in the right thoracic paravertebral space and retro-rectus plane for continuous infusion of ropivacaine 0.2% for 3 days, as well as a fentanyl patient-controlled analgesia for 7 days.

References

Aug 12, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·C McTiernan, B Haagenvik
Jan 11, 2002·Journal of Neurology, Neurosurgery, and Psychiatry·P McMonagleM Hutchinson
Feb 14, 2006·Current Neurology and Neuroscience Reports·John K Fink
May 24, 2006·Anesthesia and Analgesia·Stéphane DeruddreDan Benhamou
Jun 27, 2006·International Journal of Obstetric Anesthesia·I ThomasM Scrutton
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Feb 27, 2013·Revista brasileira de anestesiologia·José Antonio Franco-HernándezAlejandra García Hernández
Jun 3, 2017·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·J A GannonJ Hussey
Jul 7, 2017·European Journal of Anaesthesiology·Sebastien PonsonnardEdouard Marcel Gueye

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