Anesthesia for a Patient with Undiagnosed Myotonic Dystrophy.

Pub Date : 2024-04-01 Epub Date: 2024-04-29 DOI:10.4103/njcp.njcp_553_23
M O Lee, J H Lee, S H Cho, C E Kim
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Abstract

Abstract: Myotonic dystrophy (DM) is an autosomal dominant genetic disorder characterized by progressively worsening loss of muscle mass and weakness. Anesthesiologists face challenges in managing these patients due to risks such as prolonged intubation and delayed recovery associated with anesthesia in such conditions. We report a case of a 40-year-old male patient undergoing open total gastrectomy under general anesthesia. After the surgery, we administered sugammadex to reverse neuromuscular blockade and confirmed the patient's spontaneous breathing. We then proceeded to extubate the patient. However, the patient experienced complications such as apnea, desaturation, and mental changes. The patient was re-intubated and transferred to the intensive care unit for ventilator support. He was diagnosed with DM by genetic test later. Poor preoperative assessment or undiagnosed DM in surgical patients can lead to severe complications. Thus, it is important to carefully check preoperative laboratory results, patient history, and physical findings.

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为一名未确诊的肌营养不良症患者进行麻醉。
摘要:肌营养不良症(DM)是一种常染色体显性遗传疾病,其特征是肌肉质量下降和虚弱逐渐加重。麻醉医师在处理这类患者时面临着挑战,因为在这种情况下麻醉会带来插管时间延长和恢复延迟等风险。我们报告了一例在全身麻醉下接受开腹全胃切除术的 40 岁男性患者的病例。术后,我们给患者注射了苏加麦角以逆转神经肌肉阻滞,并确认了患者的自主呼吸。随后,我们为患者拔管。然而,患者出现了呼吸暂停、血氧饱和度降低和精神变化等并发症。患者被再次插管,并转入重症监护室接受呼吸机支持治疗。后来,他通过基因检测被确诊为糖尿病。手术患者术前评估不佳或未诊断出 DM 可导致严重并发症。因此,仔细检查术前实验室结果、患者病史和体格检查结果非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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