Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic Prostatectomy
Background. Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy. Case Presentation. A...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-01-01
|
| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2017/9780265 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832567969731837952 |
|---|---|
| author | Miyuki Niki Taihei Tachikawa Yuka Sano Hiroki Miyawaki Aisa Matoi Yukari Okano Nobutaka Kariya Tsuneo Tatara Munetaka Hirose |
| author_facet | Miyuki Niki Taihei Tachikawa Yuka Sano Hiroki Miyawaki Aisa Matoi Yukari Okano Nobutaka Kariya Tsuneo Tatara Munetaka Hirose |
| author_sort | Miyuki Niki |
| collection | DOAJ |
| description | Background. Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy. Case Presentation. A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). General anesthesia was performed without any problems. The patient, however, developed airway obstruction one hour after extubation and was reintubated following commencement of mechanical ventilation for one day. At the age of 70 years, the patient received an emergency tracheostomy due to bilateral vocal cord paralysis and then was diagnosed with spinal and bulbar muscular atrophy (SBMA). Although no muscle weakness of either upper or lower extremities was observed, rocuronium showed hypersensitivity during total laryngectomy under general anesthesia. Conclusions. Vocal cord paralysis combined with postoperative laryngeal edema, the cause of which was presumed to be SBMA, likely caused airway obstruction after RALP. As neuromuscular symptoms progress gradually in patients with SBMA, muscle relaxants should be used carefully, even if patients with SBMA present no immobility of their extremities. |
| format | Article |
| id | doaj-art-d85d3806338647cc95508627e3a02a30 |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-d85d3806338647cc95508627e3a02a302025-02-03T01:00:10ZengWileyCase Reports in Anesthesiology2090-63822090-63902017-01-01201710.1155/2017/97802659780265Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic ProstatectomyMiyuki Niki0Taihei Tachikawa1Yuka Sano2Hiroki Miyawaki3Aisa Matoi4Yukari Okano5Nobutaka Kariya6Tsuneo Tatara7Munetaka Hirose8Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, JapanDepartment of Anesthesia, Meiwa Hospital, Nishinomiya, Hyogo, JapanDepartment of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, JapanDepartment of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, JapanIntensive Care Unit, Hyogo College of Medicine Hospital, Nishinomiya, Hyogo, JapanDepartment of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, JapanDepartment of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, JapanDepartment of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, JapanDepartment of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, JapanBackground. Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy. Case Presentation. A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). General anesthesia was performed without any problems. The patient, however, developed airway obstruction one hour after extubation and was reintubated following commencement of mechanical ventilation for one day. At the age of 70 years, the patient received an emergency tracheostomy due to bilateral vocal cord paralysis and then was diagnosed with spinal and bulbar muscular atrophy (SBMA). Although no muscle weakness of either upper or lower extremities was observed, rocuronium showed hypersensitivity during total laryngectomy under general anesthesia. Conclusions. Vocal cord paralysis combined with postoperative laryngeal edema, the cause of which was presumed to be SBMA, likely caused airway obstruction after RALP. As neuromuscular symptoms progress gradually in patients with SBMA, muscle relaxants should be used carefully, even if patients with SBMA present no immobility of their extremities.http://dx.doi.org/10.1155/2017/9780265 |
| spellingShingle | Miyuki Niki Taihei Tachikawa Yuka Sano Hiroki Miyawaki Aisa Matoi Yukari Okano Nobutaka Kariya Tsuneo Tatara Munetaka Hirose Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic Prostatectomy Case Reports in Anesthesiology |
| title | Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic Prostatectomy |
| title_full | Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic Prostatectomy |
| title_fullStr | Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic Prostatectomy |
| title_full_unstemmed | Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic Prostatectomy |
| title_short | Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic Prostatectomy |
| title_sort | previously undiagnosed spinal and bulbar muscular atrophy as a cause of airway obstruction after robot assisted laparoscopic prostatectomy |
| url | http://dx.doi.org/10.1155/2017/9780265 |
| work_keys_str_mv | AT miyukiniki previouslyundiagnosedspinalandbulbarmuscularatrophyasacauseofairwayobstructionafterrobotassistedlaparoscopicprostatectomy AT taiheitachikawa previouslyundiagnosedspinalandbulbarmuscularatrophyasacauseofairwayobstructionafterrobotassistedlaparoscopicprostatectomy AT yukasano previouslyundiagnosedspinalandbulbarmuscularatrophyasacauseofairwayobstructionafterrobotassistedlaparoscopicprostatectomy AT hirokimiyawaki previouslyundiagnosedspinalandbulbarmuscularatrophyasacauseofairwayobstructionafterrobotassistedlaparoscopicprostatectomy AT aisamatoi previouslyundiagnosedspinalandbulbarmuscularatrophyasacauseofairwayobstructionafterrobotassistedlaparoscopicprostatectomy AT yukariokano previouslyundiagnosedspinalandbulbarmuscularatrophyasacauseofairwayobstructionafterrobotassistedlaparoscopicprostatectomy AT nobutakakariya previouslyundiagnosedspinalandbulbarmuscularatrophyasacauseofairwayobstructionafterrobotassistedlaparoscopicprostatectomy AT tsuneotatara previouslyundiagnosedspinalandbulbarmuscularatrophyasacauseofairwayobstructionafterrobotassistedlaparoscopicprostatectomy AT munetakahirose previouslyundiagnosedspinalandbulbarmuscularatrophyasacauseofairwayobstructionafterrobotassistedlaparoscopicprostatectomy |