Ketamine anaesthesia for a patient with the Shy-Dräger syndrome.

A 58-year-old man with the Shy-Dräger syndrome underwent laryngo- and tracheoscopies in general anaesthesia for evaluation of the larynx after tracheostomy following bilateral vocal cord paralysis. A profound fall in arterial pressure during anaesthesia induced with thiopentone has been demonstrated in previously reported patients with the Shy-Dräger syndrome. In the present patient, anaesthesia induced with ketamine, maintained with nitrous oxide in oxygen and supplemented with fentanyl, diazepam and suxamethonium did not cause a fall in arterial pressure.