Total intravenous anesthesia without muscle relaxant for pulmonary wedge resection in a patient with amyotrophic lateral sclerosis: a case report

Abstract

Muscle relaxants may exacerbate the symptoms of amyotrophic lateral sclerosis (ALS). Furthermore, ALS patients often experience respiratory muscle weakness. Herein, we report the case of a 63-year-old man with ALS who underwent pulmonary wedge resection using total intravenous anesthesia without muscle relaxant and single lumen endotracheal tube. After an unremarkable surgical procedure, the patient was transferred to the intensive care unit after extubation. The patient did not experience any worsening of ALS symptoms over the one-year follow-up period. Our experience shows that total intravenous anesthesia without muscle relaxants can be used as an anesthetic method for lung surgery in ALS patients. We report this case along with a brief literature review.

Keywords: Amyotrophic lateral sclerosis; general anesthesia; neurodegenerative diseases; neuromuscular blocking agents; video assisted thoracic surgery.