Radical hysterectomy in a patient with Steinert disease: spinal anaesthesia, ketamine and TAP and rectus sheath blocks
DOI:
https://doi.org/10.23938/ASSN.0290Keywords:
Myotonic dystrophy. Hysterectomy. Spinal anaesthesia. Ketamine. Rectus abdominis.Abstract
The case of a patient with Steinert disease who underwent surgery for radical hysterectomy is presented. Because of her advanced disease, she suffered from chronic respiratory failure which required non-invasive ventilation (NIV) at night. Spinal anaesthesia was chosen as an anaesthetic treatment. At the time of aortic lymphadenectomy, the patient reported moderate pain at hypogastrium, which was well controlled with boluses of 10 mg of ketamine. Postoperatively, opioid administration was avoided by applying abdominal wall blocks: transverse abdominis plane (TAP) block and sheath of rectus abdominis muscle block. The evolution of the patient was satisfactory and she was discharged on the fifth day after surgery.
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