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Indian Journal of Anesthesia and Analgesia 12(2):p 129-132, April -June 2025. | DOI: 10.21088/ijaa.2349.8471.12225.8
Case Report
Anaesthetic Management of Nephrectomy with Tuberous Sclerosis
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Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Anesthesia and Analgesia 12(2):p 129-132, April -June 2025. | DOI: 10.21088/ijaa.2349.8471.12225.8
How Cite This Article:
Pushadapu S, Kiran N. Anaesthetic management of nephrectomy with tuberous sclerosis. Ind J Anesth Analg. 2025;12(1):129-132.Timeline
Received : February 08, 2025
Accepted : April 05, 2025
Published : June 23, 2025
Abstract
Introduction: Tuberous sclerosis complex (TSC) is a rare genetic disorder characterized by the development of benign tumors in multiple organs, including the brain, skin, kidneys, heart, and lungs. It is often associated with neurological manifestations such as epilepsy, intellectual disabilities, and behavioral disorders. The management of patients with TSC, particularly those with epilepsy, presents unique challenges during surgical procedures due to their complex medical history and potential for perioperative complications. Case Report: A 24 year-old female diagnosed with left renal mass plus left adnexal mass pelvis posted for left nephrectomy + left adnexal mass excision with a known diagnosis of tuberous sclerosis complex and a history of epilepsy. It was scheduled for a left nephrectomy due to a renal angiomyolipoma. The patient had a history of frequent generalized tonic-clonic seizures despite being on antiepileptic medication. On physical examination, the patient appeared well-oriented with normal cognitive function. Multiple hypopigmented macules were present on her skin, consistent with her diagnosis of TSC. Preoperative laboratory investigations were within normal limits. Preoperative evaluation by the neurologist ensured that the patient’s antiepileptic drug (AED) regimen was optimized. recommended. Epidural was places at T12-L1; General anesthesia was induced using propofol and fentanyl, with vecuronium and maintained with O2, N2O and Isoflurane. Antiepileptic medications were given. Vitals were stable and blood was transfused. Intraoperative and post-operative period patient was stable and monitored in ICU for 1 day and shifted to postoperative ward uneventfully. Conclusion: This case highlights the successful anesthetic management of a patient with tuberous sclerosis complex and epilepsy undergoing nephrectomy. A multidisciplinary approach, careful preoperative planning, and vigilant intraoperative and postoperative monitoring are essential to minimize complications and ensure positive outcomes in such complex cases. Maintaining seizure control and avoiding perioperative triggers, while ensuring hemodynamic stability, were key factors in the management of this patient.
References
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- 2. Hung C.C., Su Y.N., Chien S.C., Liou H.H., Chen C.C., Chen P.C., et al Molecular and clinical analyses of 84 patients with tuberous sclerosis complex BMC Med Genet. 2006; 7: 72.
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Author Contributions
All authors contributed significantly to the work and approve its publication.
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This article does not involve any human or animal subjects, and therefore does not require ethics approval.
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Cite this article
Pushadapu S, Kiran N. Anaesthetic management of nephrectomy with tuberous sclerosis. Ind J Anesth Analg. 2025;12(1):129-132.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| February 08, 2025 | April 05, 2025 | June 23, 2025 |
DOI: 10.21088/ijaa.2349.8471.12225.8
Keywords
Anesthetic managementTuberous sclerosisEpilepsyNephrectomySearch for Similar Articles
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Timeline
| Received | February 08, 2025 |
| Accepted | April 05, 2025 |
| Published | June 23, 2025 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
