Individualized anesthetic strategy for day-case hemorrhoidectomy in a patient with muscular dystrophy: a case report

Abstract

Patients with muscular dystrophy face significant anesthetic challenges due to the increased risks of respiratory compromise, cardiac involvement, rhabdomyolysis, and adverse reactions to anesthetic agents. Careful planning of anesthetic techniques is particularly important in ambulatory surgery settings where rapid postoperative recovery and discharge are required. We report a case of a 31-year-old woman with muscular dystrophy who presented with symptomatic third-degree hemorrhoids. The patient had a history of extensive spinal fusion for thoracolumbar scoliosis, which made regional anesthesia technically difficult and potentially unsafe. Additionally, general anesthesia was considered a high-risk procedure because of the underlying neuromuscular disease. After preoperative evaluation, hemorrhoidectomy was successfully performed under local anesthesia. The patient was discharged without complications on the day of surgery. This case report highlights the importance of individualized anesthetic strategies in patients with muscular dystrophy undergoing anorectal surgery at a day-surgery clinic. When conventional anesthetic options are limited, local anesthesia is a safe and effective alternative. In day-case surgery, individualized anesthetic planning based on patient-specific factors, along with a meticulous and limited hemorrhoidectomy, is essential rather than rigid adherence to a single anesthetic technique.

Keywords: Ambulatory surgical procedure; Hemorrhoidectomy; Local anesthesia; Muscular dystrophy

Citation: Lee H, Lee KH. Individualized anesthetic strategy for day-case hemorrhoidectomy in a patient with muscular dystrophy: a case report. Anaesth. pain intensive care 2026;30(6):769-772. DOI: 10.35975/apic.v30i6.3273

Received: March 05, 2026; Revised: April 07, 2026; Accepted: April 26, 2026