Trigger-Free Neuraxial Anaesthesia for Emergency Evacuation of Retained Products of Conception in Limb-Girdle Muscular Dystrophy: A Case Report and Literature Review.

Limb-girdle muscular dystrophy (LGMD) carries anaesthetic risks including anaesthesia-related rhabdomyolysis, hyperkalaemia, and prolonged neuromuscular blockade. Trigger-free techniques that avoid volatile agents and depolarising neuromuscular blockers (NMBs) are preferred. A 31-year-old woman with LGMD presented four days after a second-trimester miscarriage with pain and tissue passage requiring emergency evacuation of retained products of conception (ERPC). Examination showed proximal limb weakness without cardiopulmonary compromise; routine laboratory results were normal. A vapour-free, clean anaesthesia workstation was prepared and succinylcholine/volatile agents strictly avoided. Single-shot spinal anaesthesia (0.5% hyperbaric bupivacaine 10 mg at L3-4) provided adequate surgical conditions. Intraoperative haemodynamics were stable; no sedatives or NMBs were used. Surgery lasted ~20 minutes. Recovery in the post-anaesthesia care unit (PACU) was uncomplicated with an Aldrete score of 10 and same-day discharge. For urgent gynaecological surgery in LGMD, neuraxial anaesthesia can provide reliable anaesthesia while avoiding recognised triggers of rhabdomyolysis and hyperkalaemia. Meticulous preoperative planning (vapour-free machine, avoidance of depolarising agents, and ready total intravenous anaesthesia (TIVA) backup) supports safety in this population.