Regional anesthesia for craniotomy in a patient with inflammatory myopathy

Patients with inflammatory myopathies are sensitive to multiple anesthetic agents, including sedatives, neuromuscular blockers, analgesics, and volatile inhaled anesthetics. Patients with decreased muscular physiological reserve may experience respiratory failure when exposed to these agents. We present a unique case of a patient with inflammatory myopathy, who received a regional anesthesia-based anesthetic for middle fossa craniotomy. Regional anesthetic-based techniques may decrease or obviate the need for provocative general anesthetic agents, allowing preservation of baseline muscular function. Regional anesthesia was used to facilitate the surgical procedure and provided postoperative analgesia in a patient at high risk of respiratory failure. This regional anesthesia technique facilitated an uneventful postoperative recovery.