Total intravenous anesthesia in a case of Duchenne muscular dystrophy -single low dose rocuronium usage [Duchenne musküler di?strofi?li? olguda total i?ntravenöz anestezi? -tek, düşük doz rokuronyum kullanimi]

Abstract

Duchenne Muscular Dystrophy is an X-linked progressive neuromuscular hereditary disease which effects men and is seen in 1/3.500 frequency. Although the basic problem in this disease is musclular weakness; anesthetic approach in Duchenne Muscular Dystrophy is important because the disease might cause cardiac and respiratory problems during anesthesia. Moreover, inhalation anesthetics might be the reason for malignant hyperthermia and rhabdomyolysis. This case report aims at discussing the safe anesthetic approach in a 7 year old patient who was operated by orthopedic surgeons with Duchenne Muscular Dystrophy and right supracondylar humerus fracture. In this case ventilator was totally cleaned from anesthetic agents to avoid from malignant hyperthermia and rhabdomyolysis. 50% oxygen-air mixture and low dose propofol with remifentanil were used in total intravenous anesthesia. Because of the non-depolarizing muscle relaxant sensitivity, low-dose rocuronium and sugammadex were used as its reverse agent. No complications were encountered during preoperative and perioperative period. After the case was observed in intensive care unit, he was transferred to the orthopedics clinic. It has been concluded that use of propofol and remifentanil together with total intravenous anesthesia, and low-dose rocuronium bromide will be a safer anesthesia application.