Anesthetic management for a third molar extraction in a patient with chronic inflammatory demyelinating polyneuropathy

Masatoshi Fujita, Kentaro Mizuta, Eiji Masaki

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Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease characterized by chronically progressing or relapsing neurological disease with paresthesia and weakness of the proximal and distal muscles of the limbs. We report a successful anesthetic management with a minimum use of non-depolarizing neuromuscular blocker in a patient with CIDP. A 21-year-old man (weight, 71 kg; height, 167 cm) with CIDP was scheduled for a third molar extraction under general anesthesia The patient had a 10-year history of CIDP, and had received oral steroid therapy for 10 years. Anesthesia was induced using propofol and remifentanil. Before tracheal intubation, rocuronium (30 mg) was incrementally administered under neuromuscular monitoring. After complete muscle relaxation (TOF 0) was achieved, the patient was naso-tracheally intubated. The anesthesia was maintained with propofol and remifentanil. During the operation, his vital signs were stable, and the surgery and anesthetic course were uneventful. After the end of the surgery, the effect of the neuromuscular blocker was completely reversed with the intravenous administration of sugammadex (140 mg), and the patient was extubat-ed. No postoperative events occurred. Since CIDP patients are thought to be sensitive to neuromuscular blockers, anesthesiologists should consider the possibility of hypersensitivity to non-depolarizing neuromuscular blockers, the effects of which can be reversed using sugammadex. Neuromuscular monitoring might also be potentially helpful for evaluating muscle relaxation in patients with CIDP.

Original languageEnglish
Pages (from-to)217-219
Number of pages3
JournalJournal of Japanese Dental Society of Anesthesiology
Issue number2
Publication statusPublished - 2017 Jan 1


  • CIDP
  • General anesthesia
  • Neuromuscular blocker

ASJC Scopus subject areas

  • Dentistry(all)
  • Anesthesiology and Pain Medicine


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