Ultrasound-Assisted Subarachnoid Block of a Patient with Severe Muscle Wasting for Urologic Surgery

Abstract

Muscle atrophy, also termed "muscle wasting," is defined as a reduction in muscle mass resulting from progressive muscle weakness and shrinkage. Potential causes include prolonged immobilization, inadequate nutritional intake, severe burn injuries, and a range of serious and often chronic conditions such as muscular dystrophies, renal failure, and immune-mediated disorders. We report the case of a female patient in her 60s with severe muscular wasting who presented with recurrent urinary tract infections and was scheduled for surgical intervention for cystolithiasis. The patient exhibited marked musculoskeletal deformities, including severe scoliosis, multiple joint contractures, and limited cervical mobility, and had been chronically bedridden since adolescence, for which the working impression was muscular dystrophy. In light of the elevated perioperative risk associated with the use of general anesthesia in patients with suspected neuromuscular disorders and severe restrictive pulmonary pathology, ultrasound-assisted neuraxial anesthesia was successfully performed.