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Canadian Journal of Anesthesia, Vol 45, 1103-1105, Copyright © 1998 by Canadian Anesthesiologists' Society

ARTICLES

Anaesthetic considerations in a patient with lepromatous leprosy

S Mitra, KK Gombar and S Gombar
Department of Anaesthesia, Government Medical College and Hospital, Chandigarh, India.

PURPOSE: To consider the anaesthetic problems in a patient with lepromatous leprosy undergoing general anaesthesia. CLINICAL FEATURES: A 52 yr old man with lepromatous leprosy for five years was booked for elective radical nephrectomy. He received 100 mg dapsone per day po. The patient was asymptomatic for cardiovascular disease but his electrocardiogram showed complete left bundle branch block, inferior wall ischaemia with echocardiogram findings of 58% ejection fraction and left ventricular diastolic dysfunction. Other preoperative investigations (haemogram, serum urea and creatinine, liver function tests and chest X-ray) were normal. After premedication with diazepam, meperidine and promethazine, the patient received glycopyrrolate and anaesthesia was induced with thiopentone. Atracurium was given to facilitate tracheal intubation. Anaesthesia was maintained with intermittent positive pressure ventilation using N2O in oxygen with halothane. Anaesthesia and surgery were uneventful except that the patient had a fixed heart rate that remained unchanged in response to administration of anticholinergic, laryngoscopy, intubation and extubation. CONCLUSION: Patients with lepromatous leprosy may have cardiovascular dysautonomia even when they are asymptomatic for cardiovascular disease.


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 Canadian J. AnesthesiaHome page
S. Mitra and K. K. Gombar
Leprosy and the anesthesiologist
Can J Anesth, October 1, 2000; 47(10): 1001 - 1007.
[Abstract] [PDF]


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Copyright © 1998 by the Canadian Anesthesiologists' Society.