Guillain-Barré syndrome (polyradiculoneuritis) is the acute form of a group of disorders classified as inflammatory polyneuropathies (autoimmune disease caused by a bacterial or viral infection that triggers an immune response, producing antibodies that damage the myelin sheath and cause axonal degeneration).
- This syndrome is characterized by the acute or subacute onset of skeletal muscle weakness or paralysis of the legs, which spreads cephalad and may result in difficulty swallowing and impaired ventilation from paralysis of the intercostal muscles.
- The most serious immediate problem is hypoventilation. Vital capacity should be monitored frequently. If it decreases below 15 to 20 mL/kg, mechanical ventilation of the lungs is indicated.
- Although 85% of patients with this syndrome achieve a good recovery, chronic recurrent neuropathy develops in 3% to 5% of patients.
- Autonomic nervous system dysfunction with wide fluctuations in blood pressure (physical stimulation may precipitate hypertension), tachycardia, cardiac dysrhythmias, and cardiac arrest.
- Management of Anesthesia
- Compensatory cardiovascular responses may be absent (autonomic nervous system dysfunction), resulting in significant hypotension secondary to postural changes, blood loss, or positive airway pressure. Conversely, stimuli such as laryngoscopy and tracheal intubation may produce hypertension and tachycardia.
- SCh is not recommended because drug-induced potassium release may result in hyperkalemia and cardiac arrest. The response to nondepolarizing muscle relaxants ranges from sensitivity to resistance.
- It is likely that mechanical ventilation will be required during the immediate postoperative period.