Sato Hiroaki, Okawa Iwao, Sasuga Motoi, Mitani Shigeki, Matsukawa Takashi, Kumazawa Teruo
Department of Anesthesia, Ohme City General Hospital, Ohme 198-0042.
Masui. 2002 Aug;51(8):907-9.
Patients of subacute myelo-optico-neuropathy (SMON) suffer from neurological disorders for a long time. The authors report anesthetic management of two patients with SMON. One patient was a 82-year-old woman suffering from SMON for 49 years. Sensory examination revealed numbness and hypesthesia in the both lower extremities. She underwent open reduction for femoral neck fracture. The other patient was a 91-year-old man suffered from SMON for 31 years. Sensory examination revealed weakness of leg muscles. He underwent transurethral resection of prostate. We chose general anesthesia for both patients instead of spinal anesthesia because of reported complications related to spinal anesthesia in patients with the disease. Intraoperative courses were uneventful and there were no neurological deteriorations postoperatively in both patients. One of the chief symptoms of patients with SMON is numbness of the lower extremity. Therefore patients of SMON may feel uncomfortable to the numbness by spinal or epidural anesthesia. This is the main reason we recommend general anesthesia for patients with SMON.
亚急性脊髓视神经病（SMON）患者长期患有神经系统疾病。作者报告了两名SMON患者的麻醉管理情况。一名患者是一位82岁的女性，患有SMON 49年。感觉检查显示双下肢麻木和感觉减退。她因股骨颈骨折接受了切开复位术。另一名患者是一位91岁的男性，患有SMON 31年。感觉检查显示腿部肌肉无力。他接受了经尿道前列腺切除术。由于有报道称该疾病患者进行脊髓麻醉会出现并发症，我们为两名患者均选择了全身麻醉而非脊髓麻醉。术中过程顺利，两名患者术后均未出现神经功能恶化。SMON患者的主要症状之一是下肢麻木。因此，SMON患者可能会因脊髓或硬膜外麻醉导致的麻木感而感到不适。这是我们推荐为SMON患者进行全身麻醉的主要原因。
