Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 6, Number 11, November 2015, pages 512-516

Perioperative Management of a Patient With Giant Axonal Neuropathy


Table 1. Previous Reports of Anesthetic are for Patients With GAN
Authors and referencePatient demographicsPremedicationAnesthetic techniquePerioperative problems and management
LMA: laryngeal mask airway; PSF: posterior spinal fusion.
Mitchell et al [3]An 11-year-old boy presented as an emergency for left orchiectomy following acute torsion of the testis.No premedication was given.Anesthesia was induced with thiopentone 4 mg/kg and maintained with halothane in a nitrous oxide/oxygen mixture. No NMBAs were administered.The perioperative course was uneventful. Postoperative chest physiotherapy was administered and the patient monitored for 48 h on a high dependency pediatric ward.
Diagos et al [4]A wheelchair-bound, 13-year-old boy with impaired pulmonary function presented for acute torsion of the testes.No premedication was given.Anesthesia was induced with propofol and remifentanil, and maintained with continuous infusions of the same medications. The airway was secured with an LMA.The authors avoided endotracheal intubation because of existing weakness of respiratory muscles and disturbed pulmonary function. The perioperative course was uneventful.
Kachko et al [5]A 9-year-old girl presented for PSF from T5 to L5.Premedicated with midazolam 0.3 mg/kg orally.Anesthesia was induced with propofol and remifentanil. Maintenance anesthesia included 50% nitrous oxide in oxygen and infusions of propofol at 6 mg/kg/h and remifentanil at 0.3 µg/kg/min. No description regarding NMBAs.During the procedure, the patient received autologous blood and 10 mL/kg of packed red cells. Intraoperative electrophysiological monitoring revealed smaller-than-expected baseline amplitudes and prolonged conduction times without changes before and after surgery.