Pitfalls of cubital electrical nerve stimulation for neuromuscular transmission monitoring: a case report of familial amyloid polyneuropathy. / Riesgos potenciales de la estimulación nerviosa eléctrica cubital para monitorización de la transmisión neuromuscular: reporte de un caso de polineuropatía amiloidótica familiar.
Rev Esp Anestesiol Reanim (Engl Ed)
; 2021 Sep 23.
Article
in En, Es
| MEDLINE
| ID: mdl-34565572
ABSTRACT
Transthyretin familial amyloid polyneuropathy (FAP) is a rare autosomal dominant disease that provokes systemic deposition of amyloid. It affects the nervous system and it is characterized by progressive sensory, motor, and autonomic neuropathy. Patients with FAP often require surgery and anesthetic care for hepatic transplantation and cardioverter-defibrillator/pacemaker implantation. Peripheric neuropathy is a common finding, but there are no reported cases of its interference with anesthetic neuromuscular transmission monitoring. We report a case of a FAP patient where lack of awareness and distracting factors led to misinterpretation of neuromuscular monitoring and unnecessary sedation and ventilation in the post anesthetic care unit. FAP may interfere with the usual cubital nerve neuromuscular monitoring. Anesthesiologists should be aware of potential neuromuscular compromise to find the best monitoring location for each patient. Sugammadex was safe and reliable in the antagonism of rocuronium neuromuscular blockade in this case, despite the lack of adequate quantitative monitoring.
Amyloid neuropathies, familial; Complicaciones postoperatorias; Enfermedades del sistema nervioso periférico; Monitorización neuromuscular; Neuromuscular monitoring; Neuropatías amiloides, familiares; Patient safety; Peripheral nervous system diseases; Postoperative complications; Seguridad del paciente
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Collection:
01-internacional
Database:
MEDLINE
Language:
En
/
Es
Journal:
Rev Esp Anestesiol Reanim (Engl Ed)
Year:
2021
Document type:
Article