This is the case of a 76 y/o AA man with a past medical history of Hypertension
and Guillain Barre Syndrome (GBS), who presented for a median sternotomy and
excision of a thymic mass after workup for multiple episodes of syncope
revealed the thymic mass. Intraoperatively, the patient had 2 episodes of
cardiac arrest with asystole. He was adequately resuscitated and extubated. He
was later determined by Neurology to have severe autonomic dysfunction and not
a candidate for any elective surgery.
References
[1]
Fletcher, D.D., Lawn, N.D., Wolter, T.D. and Wijdicks, E.F. (2000) Long-Term Outcome in Patients with GuillainBarre Syndrome Requiring
Mechanical Ventilation. Neurology, 54, 2311-2315. http://dx.doi.org/10.1212/WNL.54.12.2311
[2]
Schottlender, J.G., Lombardi, D., Toledo, A., Otero, C., Mazia, C. and Menga, G. (1999) Respiratory Failure in Guillain- Barre Syndrome. Medicina, 59, 705-709.
Chan, L.Y.S., Tsui, M.H.Y. and Leung, T.N. (2004) Guillain-Barré Syndrome in Pregnancy. Acta Obstetricia et Gynecologica Scandinavica, 83, 319-325.
[5]
Kocabas, S., Karaman, S., Firat, V., et al. (2007) Anesthetic Management of Guillain-Barré Syndrome in Pregnancy. Journal of Clinical Anesthesia, 19, 299-302. http://dx.doi.org/10.1016/j.jclinane.2006.09.008
[6]
Koller, H., Kieser, B.C., Jander, S., et al. (2005) Chronic Inflammatory
Demyelinating Polyneuropathy. The New England Journal
of Medicine, 352, 1143-1156. http://dx.doi.org/10.1056/NEJMra041347
[7]
Hines, R.L. and Marschall, K. (2008) Stoelting’s Anesthesia and Co-Existing Disease, 5th Edition, Elsevier Saunders, Philadelphia,
Chapter 9.
Weiss, S.J. and Ochroch,
E.A. (2009) Longnecker’s Anesthesiology. McGraw Hill Medical, New York, Chapter 53.
[10]
Pandey, C.K., Bose, N., Garg, G., Singh, N., Baronia, A., Agarwal, A., Singh, P.K. and Singh, U. (2002) Gabapentin for the Treatment of Pain in GuillainBarre Syndrome: A
Double-Blinded, Placebocontrolled, Crossover Study. Anesthesia & Analgesia, 95, 1719-1723. http://dx.doi.org/10.1097/00000539-200212000-00046
[11]
Morgan, G.E., Mikhail, M.S. and Murray, M.J. (2008) Neuromuscular Blocking Agents, Clinical Anesthesiology. 4th Edition, McGraw Hill, USA, 178-197.
[12]
Hara, K., Minami, K., Takamoto, K., Shiraishi, M. and Sata, T. (2000) The Prolonged Effect of a Muscle
Relaxant in a Patient with Chronic Inflammatory Demyelinating
Polyradiculoneuropathy. Anesthesia & Analgesia, 90, 224-226. http://dx.doi.org/10.1097/00000539-200001000-00045