[Anesthesia for a patient with spinocerebellar degeneration--with special reference to neuromuscular blockade monitoring].

A 51 year-old female with spinocerebrellar degeneration was anesthetized with O2-N2O-isoflurane for abdominal total hysterectomy. After monitoring of both orbicularis oculi and adductor pollicis twitches in the response to train-of-four stimulation of the facial and ulnar nerves had been prepared, vecuronium was administered as a bolus. The time from vecuronium injection to forth twitch abolishment is known to be longer with the adductor pollicis than with the orbicularis oculi. In our case, however, neuromuscular blockade showed a faster onset with the adductor pollicis. The onset with the adductor pollicis did not indicate good intubating conditions. In patients with spinocerebrellar degeneration, the twitch response of the orbicularis oculi should be monitored to determine accurately the degree of neuromuscular blockade when neuromuscular blocking drugs are administered.