Coimbra Miguel, Fernandes Sara, Sousa Ana, Cortesão Joana, Azenha Marta
Anesthesiology, Unidade Local de Saúde de Coimbra, Coimbra, PRT.
Cureus. 2025 Aug 19;17(8):e90517. doi: 10.7759/cureus.90517. eCollection 2025 Aug.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare autoimmune neuropathy characterized by progressive motor and sensory dysfunction. Anesthetic management is challenging due to increased sensitivity to neuromuscular blockers, heightened pain perception, and potential postoperative respiratory compromise. There is limited evidence on the feasibility of outpatient surgery in CIDP patients. We present the case of a 62-year-old male with stable CIDP who underwent minimally invasive transforaminal lumbar interbody fusion (TLIF) as a day-case procedure. Anesthetic management included total intravenous anesthesia (TIVA) without neuromuscular blockade, careful intra- and postoperative monitoring, and multimodal analgesia. The patient experienced no complications and was safely discharged within 24 hours. This report supports the potential feasibility of outpatient spinal surgery in carefully selected CIDP patients, highlighting the importance of multidisciplinary planning and institutional capacity for safe perioperative care.
慢性炎性脱髓鞘性多发性神经病（CIDP）是一种罕见的自身免疫性神经病，其特征为进行性运动和感觉功能障碍。由于对神经肌肉阻滞剂敏感性增加、痛觉增强以及术后潜在的呼吸功能不全，麻醉管理具有挑战性。关于CIDP患者门诊手术可行性的证据有限。我们报告一例62岁男性稳定期CIDP患者，接受了微创经椎间孔腰椎椎体间融合术（TLIF）作为日间手术。麻醉管理包括无神经肌肉阻滞的全静脉麻醉（TIVA）、细致的术中和术后监测以及多模式镇痛。患者未出现并发症，并在24小时内安全出院。本报告支持在精心挑选的CIDP患者中进行门诊脊柱手术的潜在可行性，强调了多学科规划和安全围手术期护理的机构能力的重要性。
