ArticleCureus2025
Trigger-Free Neuraxial Anaesthesia for Emergency Evacuation of Retained Products of Conception in Limb-Girdle Muscular Dystrophy: A Case Report and Literature Review.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Limb-girdle muscular dystrophy (LGMD) carries anaesthetic risks including anaesthesia-related rhabdomyolysis, hyperkalaemia, and prolonged neuromuscular blockade. Trigger-free techniques that avoid volatile agents and depolarising neuromuscular blockers (NMBs) are preferred. A 31-year-old woman with LGMD presented four days after a second-trimester miscarriage with pain and tissue passage requiring emergency evacuation of retained products of conception (ERPC). Examination showed proximal limb weakness without cardiopulmonary compromise; routine laboratory results were normal. A vapour-free, clean anaesthesia workstation was prepared and succinylcholine/volatile agents strictly avoided. Single-shot spinal anaesthesia (0.5% hyperbaric bupivacaine 10 mg at L3-4) provided adequate surgical conditions. Intraoperative haemodynamics were stable; no sedatives or NMBs were used. Surgery lasted ~20 minutes. Recovery in the post-anaesthesia care unit (PACU) was uncomplicated with an Aldrete score of 10 and same-day discharge. For urgent gynaecological surgery in LGMD, neuraxial anaesthesia can provide reliable anaesthesia while avoiding recognised triggers of rhabdomyolysis and hyperkalaemia. Meticulous preoperative planning (vapour-free machine, avoidance of depolarising agents, and ready total intravenous anaesthesia (TIVA) backup) supports safety in this population.
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