Myotonia and Neuromuscular Blocking Agents

Mitchell, Mark; Ali, Hassan H.; Savarese, John J.

doi:10.1097/00132586-197906000-00014

Cited by 13 publications

(25 citation statements)

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“…Though prolonged weakness due to incomplete reversal may occur 6 , there is only a single, poorly documented, but widely quoted report of myotonia after neostigmine 18 . Neostigmine-induced myotonia could not be confirmed by Mitchell 14 . If a muscle relaxant cannot be avoided completely, the shortacting non-depolarizing muscle relaxants and waiting for spontaneous recovery has been suggested 6,18 .…”

Section: Discussionmentioning

confidence: 82%

“…The use of succinylcholine in myotonic dystrophy is controversial. Due to the mixed reports of both normal and myotonic responses, most authors recommend avoiding it 1,6,8,9,14 . A series by Mitchell et al 9 reported a case of dose-dependent contracture following succinylcholine.…”

Section: Discussionmentioning

confidence: 99%

“…The response to nondepolarizing muscle relaxants, in the absence of any marked muscle wasting, is reported to be normal 6,8,14 . Whilst no prolonged adverse effects were noted in the six patients in this series who received nondepolarizing muscle relaxants, evoked twitch tension and recovery times were not measured.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Anaesthesia and Myotonia—An Australian Experience

2001

Anaesth Intensive Care

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“…This is consistent with experience in patients with the adult form of the disease. 10 Clinical problems in adult myotonic dystrophy include predominantly distal muscle wasting and weakness along with increased fatiguability and weakness of the diaphragm. II This pathology may affect muscle relaxant use.…”

Section: Discussionmentioning

confidence: 99%

Congenital Myotonic Dystrophy in Children — A Review of Ten Years’ Experience

Anderson

Brown

1989

Anaesth Intensive Care

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A review of the anaesthetic management of children with congenital myotonic dystrophy anaesthetised at the Royal Children 's Hospital over the past ten years is presented. Seven children underwent a total of fourteen anaesthetics. Anaesthetic considerations must include the degree of muscle weakness and hypotonia altering muscle relaxant requirements, aspiration risk due to palatopharyngeal dysfunction, and cardiomyopathy. Succinylcholine caused muscle contracture in a patient without clinical myotonia. This drug should be avoided. Although a low threshold to institute postoperative respiratory support must exist when treating neonates and infants, the older children did not clinically exhibit increased sensitivity to respiratory depressant drugs.

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“…It is well known that myotonic patients who receive succinylcholine will display muscle rigidity that is self limited, but frightening to the clinician (Mitchell, Ali & Savarese 1978). The association of such rigidity with MH has not been clarified, but until recently the two syndromes were thought to be unrelated.…”

Section: The Myotonilzsmentioning

confidence: 99%