ANESTHETIC MANAGEMENT USING TIVA IN A PATIENT WITH LIMB-GIRDLE MUSCULAR DYSTROPHY: A CASE REPORT

Abstract

Limb-Girdle Muscular Dystrophy (LGMD) is a group of progressive neuromuscular disorders characterized by proximal muscle weakness, affecting mobility and respiratory function. The perioperative management of LGMD patients presents significant challenges due to their susceptibility to respiratory compromise, cardiac involvement, and adverse reactions to certain anesthetic agents. We report the case of a 34-year-old male diagnosed with LGMD in 2013, who presented with a right- sided neck swelling requiring surgical incision and drainage under general anesthesia. The patient had no prior cardiac or respiratory compromise but exhibited severe lower limb weakness (0/5) and moderate upper limb weakness (4/5). A total intravenous anesthesia (TIVA) approach was employed to avoid the risk of malignant hyperthermia associated with volatile anesthetics.The patient underwent successful intubation using a CMAC video laryngoscope, and anesthesia was maintained with oxygen and air without inhalational agents. This case highlights the importance of individualized anesthetic management in LGMD patients, emphasizing preoperative evaluation, avoiding high-risk agents, and careful airway management. With a multidisciplinary approach and perioperative vigilance, safe anesthetic care can be achieved, minimizing complications and ensuring optimal surgical outcomes.