Real-time ultrasound-guided sacral plexus block combined with mild sedation for hemorrhoidectomy and hemorrhoidal artery ligation in a patient with amyotrophic lateral sclerosis: A case report

Abstract Patients with amyotrophic lateral sclerosis (ALS) present perioperative challenges for clinical anesthesiologists for anesthesia-associated complications. A 54-year-old woman with a 2-year history of ALS was scheduled for hemorrhoidectomy and hemorrhoidal artery ligation. We performed real-time ultrasound-guided sacral plexus block with dexmedetomidine under standard monitoring. The anesthesia method met the surgical demands and avoided respiratory complications during the procedures. There was no neurological deterioration after the surgery and 3 months after the patients were discharged. Real-time ultrasound-guided sacral plexus block combined with mild sedation may be an effective and safe technique in patients with ALS undergoing hemorrhoidectomy and hemorrhoidal artery ligation.