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Baclofen Pump Replacement in a Patient With End-Stage Amyotrophic Lateral Sclerosis: A Case Report Demonstrating Transversus Abdominis Plane Block as the Sole Anesthetic

Hadaya, Iman, A., MD*; Gray, Andrew, T., MD, PhD; Braehler, Matthias, R., MD, PhD

doi: 10.1213/XAA.0000000000000676
Case Reports

A patient with end-stage amyotrophic lateral sclerosis (ALS) presented for Baclofen pump replacement. She underwent a left transversus abdominis plane block to anesthetize the left lower quadrant of the abdomen. No sedatives or analgesics were administered, and the procedure was successfully completed without complication. It is prudent to consider anesthetic plans that avoid complications associated with general or neuraxial anesthesia in patients with ALS. This case report demonstrates successful placement of a transversus abdominis plane block in a patient with ALS and offers a safe anesthetic technique that can be performed in other high-risk patients.

From the *Department of Anesthesia and Perioperative Care, University of California, San Francisco, California

Department of Anesthesia and Perioperative Care, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, California

Department of Anesthesia and Perioperative Care, University of California, San Francisco, California.

Accepted for publication October 6, 2017.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Iman A. Hadaya, MD, University of California, 2984 Clay St #2, San Francisco, CA 94115. Address e-mail to Iman.Hadaya@ucsf.edu.

© 2018 International Anesthesia Research Society
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