Spinal anesthesia in a patient with Charcot-Marie Tooth disease, who underwent osteosynthesis with tibia nail plate

Introduction: Charcot-Marie Tooth disease is a hereditary peripheral neuropathy characterized by muscular atrophy and sensitive,progressive neuropathy. The authors describe the clinical case of a patient with the disease, who underwent subarachnoid spinalblock for orthopedic surgery following a fracture of the left tibia. The patient also had limited neck movement, small mouth rim,reduced bite space (approximately 3cm), and Mallampati Score: Class III. Although there is not much literature on anesthesia forthis disease intervention, there is some concern about the use of muscle relaxant drugs due to a risk of prolonged action as in thecase of vecuronium, and hypercalcemia as in local anesthetics.Case presentation: The subarachnoid spinal block was performed through an injection of 4ml Ropivacaine 0.5% in level L4-L5 of the subarachnoid space, using a Whitaker type 25G needle, without bleeding or immediate complications. Although there isscarce literature on the subject, this case confirms the prior evidence that this type of local anesthesia is acceptable in surgery forthis disease. In addition, this form of local-regional anesthesia proved useful to reduce the risk of upper respiratory problems due toabnormal anatomy.Results: The operation proceeded without any problems, and there were no immediate or long-term complications attributableto the subarachnoid anesthesia observed in the postoperative period.