Case 96 - Guillain-Barrésyndrome

Summary

Guillian-Barré syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy affecting approximately 1-2/100,000 each year. This chapter presents a case study of a 50-year-old male who was scheduled to undergo emergent exploratory laparotomy. Preoperative evaluation including history, physical examination, electrocardiogram and laboratory data such as cerebrospinal fluid and nerve conduction studies helps identify patients who require postoperative mechanical ventilation. Stress-dose steroids should be administered to all patients who have been on steroids to reduce risk of cardiovascular collapse due to inhibition of endogenous cortisol production. Autonomic instability can cause severe hypotension/hypertension intraoperatively necessitating the use of invasive intra-arterial blood pressure monitoring. Opioids may be used to treat pain in the perioperative period in the intensive care units (ICUs). Early preoperative assessment, adequate monitoring, appropriate selection of anesthetic technique and postoperative intensive care treatment can lead to uneventful anesthetic management in GBS patients.