Delayed Extubation of a Patient With Multiple Sclerosis

Abstract

The potential complications associated with gastroparesis in the perioperative setting for patients with multiple sclerosis (MS) are inadequately recognized. While gastroparesis is commonly associated with diabetes mellitus-induced neuropathy and postsurgical complications, its prevalence and impact on patients with MS are less understood. This is particularly crucial as the systemic autoimmune nature of MS may extend its neurological effects to the gastrointestinal (GI) tract. In this context, we present a case wherein undiagnosed gastroparesis significantly contributed to postoperative challenges, leading to delayed extubation in a patient with MS. This underscores the importance of considering gastroparesis as a potential differential diagnosis and developing a comprehensive approach to evaluating and managing MS patients, which may help mitigate perioperative complications and inform tailored anesthetic management strategies.

Keywords: delayed emergence; delayed extubation; gastroparesis; general anesthesiology; multiple sclerosis.

Figure 1. Chest X-ray showing large gastric bubble pre-OG tube placement

OG: orogastric

Figure 2. Chest X-ray after OG tube placement

OG: orogastric