Anesthetic Management of a Patient with Chronic Inflammatory Demyelinating Polyneuropathy Undergoing Emergency Umbilical Herniorrhaphy: A Case Report

Sogol  Asgari; Parisa  Sezari; Morteza  Mortazavi; Faranak  Behnaz

doi:10.18502/aacc.v11i4.19382

Sogol Asgari Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Parisa Sezari Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Morteza Mortazavi Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Faranak Behnaz Department of Anesthesiology, School of Medicine Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v11i4.19382

Keywords: Anesthetic management; Neuromuscular disorders; Chronic inflammatory demyelinating polyneuropathy; Emergency surgery

Abstract

Neuromuscular disorders are a wide range of conditions that weaken muscles. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an uncommon acquired immune-mediated prejunctional disorder that is not caused by an injury. This case report presents the anesthetic management of a 48-year-old male patient diagnosed with CIDP who required an emergency umbilical herniorrhaphy. The patient, weighing 95 kg and with a height of 172 cm, presented with acute abdominal pain, nausea, and vomiting, and had a notable history of intravenous immunoglobulin (IVIg) treatment and oral opium addiction. Anesthesia was induced using rapid sequence induction techniques, and general anesthesia was maintained with total intravenous anesthesia (TIVA). The operation was completed without complications, despite the patient experiencing transient symptoms of Raynaud's phenomenon during the procedure. Postoperatively, the patient had an uneventful recovery without respiratory complications or exacerbation of CIDP symptoms. This case highlights the complexities of anesthetic management in patients with CIDP due to potential risks associated with neuromuscular weakness, muscle relaxants, and the effects of immunosuppressive therapies. Further research is warranted to standardize anesthetic protocols for this patient population.