Spinal anesthesia for muscle biopsy in an infant with a suspected neuromuscular disorder: a case report

JA Clin Rep. 2020 Oct 19;6(1):84. doi: 10.1186/s40981-020-00392-x.

Abstract

Background: Neuromuscular disorders (NMDs) occur in different forms and are generally diagnosed using muscle biopsy. Among the available anesthetic management options for infants with a suspected NMD are general anesthesia (GA) and regional anesthesia (RA), including spinal anesthesia (SA). Anesthesia selection is often challenging from the point of potential airway risks and anesthetic drug-related complications.

Case presentation: A 6-month-old male infant repeatedly underwent endotracheal intubation and extubation after birth because of respiratory muscle weakness and copious secretions. He was suspected of having NMD and was scheduled for muscle biopsy. His generalized hypotonia and decreased respiratory function presented a potentially difficult airway and complicated the selection of an appropriate anesthetic method. We selected SA and dexmedetomidine, which are safe for infants.

Conclusion: We report the successful and effective anesthetic management of SA and dexmedetomidine in an infant with a suspected NMD.

Keywords: Dexmedetomidine; Infant; Muscle biopsy; Neuromuscular disorder; Regional anesthesia; Spinal anesthesia.