Work

Total intravenous anesthesia without neuromuscular blockers for ureteral lithotripsy in an ALS patient with orthopnea: a case report

Year: 2025

Type: article

Abstract: Patients with amyotrophic lateral sclerosis (ALS) rarely need urological surgery. This case report describes the successful use of total intravenous anesthesia (TIVA) with propofol and remifentanil combined with laryngeal mask airway (LMA) ventilation in a 55-year-old ALS patient with severe orthopnea who underwent ureteral lithotripsy. Given the progressive respiratory muscle weakness and inability to tolerate supine positioning, a tailored anesthetic approach is imperative. By avoiding neuromuscular blockers and minimizing opioid doses, we aimed to reduce postoperative respiratory depression. The procedure was completed uneventfully, with stable hemodynamics and rapid postoperative recovery. This case underscores the importance of individualized anesthetic strategies in neuromuscular disorders to optimize safety and outcomes.

Source: BMC Anesthesiology

DOI: 10.1186/s12871-025-03561-6

Authors: Yongxin Sun, Qianwei Zhong, Xiaoli Chu, Di Wan, Yunsheng Peng

Institution: Binzhou Medical University

Language: English

Topic: Anesthesia and Sedative Agents

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,190