Anesthetic management for a patient with multiple sclerosis at exacerbation stage under general anesthesia
Yamashita, K.; Yokoyama, T.; Tokai, H.; Imazu, Y.; Lee, M.; Manabe, M.
Masui. Japanese Journal of Anesthesiology 52(5): 521-523
2003
ISSN/ISBN: 0021-4892 PMID: 12795136 Document Number: 566014
A 39-year-old woman with multiple sclerosis (MS) at exacerbation stage underwent dilatation and curettage. MS is characterized by chronic inflammation, demyelination, and gliosis in the central nervous system. Surgical stress often induces exacerbation of MS symptoms. Therefore, deep anesthesia is required for anesthetic management in cases of MS. We monitored electroencephalograph (EEG), spectral edge frequency 90 (SEF 90), spectral median frequency (SMF) and delta-amplitude for depth of anesthesia using pEEGTM (Drager, Germany). In this case, anesthesia was induced with sevoflurane and gradually increased to 5% in oxygen 4 l cntdot min-1 and maintained with sevoflurane 2-3% in 2 nitrous oxide l cntdot min-1 and 2 l cntdot min-1 oxygen. Surgery was completed and no spike wave was observed by pEEGTM monitoring during surgery. In conclusion, sevoflurane anesthesia was useful for a patient with MS during exacerbation stage.