Anaesthesia and myotonia

Johnson, George; Chadwick, Sharon; Eadsforth, Peter; Hartopp, I

doi:10.1093/bja/75.1.113

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…Propofol has been used in patients with myotonia with variable responses, including prolonged recovery, altered dose-response curves, precipitation of myotonias and uneventful administration. [78] Considering this we used propofol for induction only and not for maintenance of anaesthesia. As our patient had absence of cardiovascular system involvement, we used desflurane for the maintenance of anaesthesia and it provided good control over anaesthetic depth as well as haemodynamics.…”

Section: Discussionmentioning

confidence: 99%

Desflurane anaesthesia in myotonic dystrophy

2011

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Myotonic dystrophy (MD) is a rare genetic disorder with multisystem involvement characterised by myotonia and progressive muscle weakness and wasting. These patients pose significant challenges to the anaesthesiologist in view of the muscular and extramuscular involvement and sensitivity to anaesthetic drugs. The literature is replete with reports of postanaesthetic respiratory and cardiovascular complications in these patients. But an ideal anaesthetic technique in MD patients remains to be determined. Rapid recovery is desirable to reduce postoperative respiratory complications. Though there are a few case reports of maintenance of anaesthesia with isoflurane and sevoflurane, there are scanty reports of use of desflurane in these patients. We present successful management of a patient with MD for laparoscopic cholecystectomy using a carefully titrated desflurane-based anaesthesia and discuss the perioperative considerations.

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Section: Discussionmentioning

confidence: 99%

Desflurane anaesthesia in myotonic dystrophy

2011

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“…The response to thiopentone and propofol in myotonic patients is varied. Several case studies have reported increased sensitivity to intravenous induction agents, with prolonged recovery times postoperatively 8,10,11 . The reported prolonged respiratory depression seen following thiopentone has led some authors to advise against its use 1 .…”

Section: Discussionmentioning

confidence: 99%

Anaesthesia and Myotonia—An Australian Experience

2001

Anaesth Intensive Care

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The purpose of this audit was to retrospectively examine the anaesthetic technique and perioperative complications among adult patients with confirmed myotonic dystrophy who presented for surgery at Royal Perth Hospital. A total of 18 general anaesthetics, two spinal anaesthetics, one conscious sedation and six eye blocks were performed. No deaths and no myotonic episodes were described despite the use of a variety of techniques, including the administration of succinylcholine to three patients. The only patient to experience postoperative complications was severely unwell preoperatively and underwent upper abdominal surgery. The audit revealed an overall complication rate of 5.5% of general anaesthetics or 3.8% of all anaesthetics in this patient population.

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“…It is of interest to note that in some of these reports, propofol in myotonic patients is not without observed side effects; there have been variable responses, marked sensitivity to its depressant effects, and even precipitation of myotonia reported with its use. 8,33 There are several potential limitations of our experimental approaches. First, in these isolated muscle bundles there is no vascular perfusion, and thus if diameters are too large, adequate oxygenation of centralized fibers may be limited.…”

Section: Volatile Agentsmentioning

confidence: 99%

“…6 To date, there exist reports of aggravating and improving myotonia associated with the use of either propofol or volatile agents. [7][8][9] The aim of the present study was to investigate the in vitro effects of propofol and inhalational anesthetic agents on pharmacologically induced (with 9-anthracenecarboxylic acid [9-AC]) chloride channel myotonia.…”

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confidence: 99%