• A&A practice · May 2022

    Case Reports

    Combined Spinal-Epidural for Loop Ileostomy in a Patient With End-Stage Amyotrophic Lateral Sclerosis: A Case Report.

    • Anna F Roth and Mark J Harris.
    • From the Department of Anesthesiology, New York Presbyterian/Weill Cornell Medical Center, New York, New York.
    • A A Pract. 2022 May 1; 16 (5): e01588.

    AbstractAnesthesia can be a challenge for patients with amyotrophic lateral sclerosis (ALS). This progressive neurological disease is associated with a high risk of aspiration and postoperative ventilatory failure. Our patient was a 72-year-old man with ALS, quadriplegia, bulbar symptoms, dysphagia, and dysarthria who underwent palliative exploratory laparotomy and loop ileostomy creation. He received a single-shot spinal anesthetic at L4-L5 and a thoracic T11-12 epidural. He tolerated the procedure well with no perioperative pulmonary complications or worsening of his ALS. To reduce the risks of general anesthesia, we chose a neuraxial approach.Copyright © 2022 International Anesthesia Research Society.

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