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KMID : 1155520180130010030
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Anesthesia and Pain Medicine
2018 Volume.13 No. 1 p.30 ~ p.33
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Use of remifentanil and propofol without muscle relaxant with Duchenne muscular dystrophy - A case report -
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Kim Heung-Soo
Baek Seung-Youp
Park Dong-Ho
Ryu Keon-Hee
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Abstract
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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.
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KEYWORD
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Airway management, Duchenne muscular dystrophy, Intravenous anesthesia, Neuromuscular blocking agents
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