Spinal Anesthesia Management in Central Core Disease: A Case Report
Central core disease is a rare neuromuscular disorder associated with leg weakness. It is a familial disease with autosomal dominant inheritance. Central core disease has been reported to be associated with malignant hyperthermia. A 25-year-old woman with central core disease was scheduled to be operated for lumbar disc hernia at L4-5 and L5-S1 interspaces. Oral dantrolene was administered prophylactically. Spinal anesthesia was performed with a 25 G Whitacre spinal needle at the L3-4 interspace. No complication was observed during the intraoperative and postoperative periods. We present a case with central core disease who was operated under spinal anesthesia with oral prophylactic dantrolene.
Spinal Anesthesia Management in Central Core Disease: A Case Report
Central core disease is a rare neuromuscular disorder associated with leg weakness. It is a familial disease with autosomal dominant inheritance. Central core disease has been reported to be associated with malignant hyperthermia. A 25-year-old woman with central core disease was scheduled to be operated for lumbar disc hernia at L4-5 and L5-S1 interspaces. Oral dantrolene was administered prophylactically. Spinal anesthesia was performed with a 25 G Whitacre spinal needle at the L3-4 interspace. No complication was observed during the intraoperative and postoperative periods. We present a case with central core disease who was operated under spinal anesthesia with oral prophylactic dantrolene.
___
- 1. Gulati S, Salhotra A, Sharma MC, Sarkar C, Kalra V. Central core disease. Indian J Pediatr 2004; 71: 1021-1024.
- 2. Miller JD, Rosenbaum H. Muscle disease. In: Benumof JL, editor. Anesthesia and Uncommon Diseases. 4th ed. WB Saunders Company: Philadelphia; 1998. pp.316-397.
- 3. Quinlivan RM, Muller CR, Davis M, Laing NG, Evans GA, Dwyer J et al. Central core disease: clinical, pathological, and genetic features. Arch Dis Child 2003; 88: 1051-1055.
- 4. Goto S, Ogata K, Fujie T, Fujigaki T, Nakamura H, Yukinari T et al. Caesarean section in a patient with past history of fulminant malignant hyperthermia. Masui 1993; 42: 271-275.
- 5. Matsuoka N, Fukuda I, Kira M, Uchihashi Y, Satou T. The use of epidural ropivacaine for a gravida with disposition for malignant hyperthermia. Masui 2004; 53: 277-279.
- 6. Flewellen EH, Nelson TE, Jones WP, Arens JF, Wagner DL. Dantrolene dose response in the awake man: implications for management of malignant hyperthermia. Anesthesiology 1983; 59: 275-280.
- 7. Oikkonen M, Rosenberg PH, Björkenhaim JM, Paetau A, Huopaniemi T. Spinal block, after dantrolene pretreatment, for resection of a thigh muscle herniation in a young malignant hyperthermia susceptible man. Acta Anaesthesiol Scand 1987; 31: 309-311.
- 8. Allen GC. Oral dantrolene. Anaesthesia 2004; 59: 1139.
- 9. Bernhardt D. Transient normalisation of CK blood levels in patients susceptible to malignant hyperthermia by oral administration of dantrolene. Anaesthesist 1982; 31: 252-254.
- 10. Sariego M, Bustos A, Guerola A, Romero I, Garcia-Baquero A. Anesthesia for cesarean section in a case of Emery-Dreifuss muscular dystrophy. Rev Esp Anestesiol Reanim 1996; 43: 288- 290.
- 11. Lucy SJ. Anaesthesia for caesarean delivery of a malignant hyperthermia susceptible parturient. Can J Anaesth 1994; 41:1220-1226.
- 12. Abballe C, Primieri P, De Cosmo G. The use of subarachnoid bupivacaine analgesia in malignant hyperthermia susceptible subjects. A clinical case report. Minerva Anestesiol 1993; 59: 335-338.