Dexmedetomidine infusion for sedation of a patient with multiple system atrophy during spinal anesthesia

Abstract

Multiple system atrophy (MSA) is a progressive neurodegenerative disorder characterized by extra-pyramidal symptoms, cerebellar ataxia, and autonomic dysfunction. The perioperative management of patients with MSA is challenging primarily due to autonomic dysfunction and vocal cord paralysis. Dexmedetomidine (DEX) is a highly selective a2-adrenoreceptor agonist that is used as a sedative, causing minimal depression of the respiratory function. We administered DEX continuously for sedation during spinal anesthesia for bipolar hip arthroplasty in a patient with MSA, without any cardiovascular or respiratory complications. This is the first case report of the efficacy of DEX for the sedation of a patient with MSA during spinal anesthesia