Anesth Pain Med.  2018 Jan;13(1):30-33. 10.17085/apm.2018.13.1.30.

Use of remifentanil and propofol without muscle relaxant with Duchenne muscular dystrophy: A case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Eulji University Hospital, Daejeon, Korea. ryu4912@naver.com

Abstract

Duchenne muscular dystrophy (DMD) is a relatively rare muscle disease with severe symptoms. Owing to the commonly limited mouth opening, cervical spine immobility, and deformation, DMD patients often present with a difficult airway. Patients with DMD are sensitive to sedation, anesthesia, and neuromuscular blockade. This risk increases as the disease progresses with age. The anesthetic management of these patients can cause various issues, presenting a challenge to anesthesiologists. We administered anesthesia for an orchiectomy in a patient with testicular cancer using total intravenous anesthesia with propofol and remifentanil without muscle relaxants. Although the patient was Mallampati grade IV due to neck stiffness, tracheal intubation was successfully performed with a portable videolaryngoscope. The intraoperative course was uneventful and recovery was rapid without postoperative complications. In conclusion, anesthesia without a muscle relaxant was successful and the patient recovered rapidly, even with a difficult tracheal intubation.

Keyword

Airway management; Duchenne muscular dystrophy; Intravenous anesthesia; Neuromuscular blocking agents

MeSH Terms

Airway Management
Anesthesia
Anesthesia, Intravenous
Humans
Intubation
Mouth
Muscular Dystrophy, Duchenne*
Neck
Neuromuscular Blockade
Neuromuscular Blocking Agents
Orchiectomy
Postoperative Complications
Propofol*
Spine
Testicular Neoplasms
Neuromuscular Blocking Agents
Propofol

Figure

  • Fig. 1 The patient’s jaw movement and rotation, were limited due to cervical fixation or contraction.


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