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Management of a patient with familial amyloid polyneuropathy type I with lumbar epidural anaesthesia

Published online by Cambridge University Press:  16 August 2006

S. Shono ,
K. Higa ,
M. Sakimura  and
K. Dan
S. Shono
Affiliation:
Division of Anesthesiology, Arao City Hospital, Arao City Present address: Department of Anesthesiology, School of Medicine, Fukuoka University, Fukuoka, Japan.
K. Higa
Affiliation:
Department of Anesthesiology, School of Medicine, Fukuoka University, Fukuoka, Japan
M. Sakimura
Affiliation:
Department of Anesthesiology, School of Medicine, Fukuoka University, Fukuoka, Japan Present affiliation: Sakimura Medical Clinic, Futsukaichi, Japan.
K. Dan
Affiliation:
Department of Anesthesiology, School of Medicine, Fukuoka University, Fukuoka, Japan
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Abstract

Familial amyloid polyneuropathy (FAP) type I is a rare disease characterized by sensorimotor polyneuropathy, and autonomic nervous system and cardiac conduction system dysfunction. Severe bradyarrhythmia and hypotension may occur during anaesthesia and surgery in patients with the FAP type I. Only one report has been published of a patient with FAP type I who was managed with epidural anaesthesia. The present authors report a 38-year-old Japanese man with a permanent pacemaker because of advanced FAP type I who underwent rotation flap of the gluteus maximus muscle to cover a trophic ulcer in the sacral region under lumbar epidural anaesthesia. Ten millilitres of adrenaline (1:200 000) was injected around the ulcer prior to surgical manipulation. Neither bradycardia nor hypotension developed during the procedures. The haemodynamic changes under lumbar epidural anaesthesia in FAP type I are discussed.

Keywords

adrenalineanaesthesiaepidural anaesthesiaarrhythmiasatrioventricular blockfamilial amyloid polyneuropathy
Type
Case Report
Information
European Journal of Anaesthesiology , Volume 15 , Issue 2 , March 1998 , pp. 242 - 245
Copyright
1998 European Society of Anaesthesiology

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