title: [Three times of anesthetic management in a patient with myotonic dystrophy].
abstract: A 38-year-old female, at 38-week gestation, was scheduled for cesarean section under epidural anesthesia. After the delivery, it was found that she had been diagnosed as myotonic dystrophy by the other physician and the neonate was a floppy infant indicating hereditary neuromuscular diseases. In her case, myotonic dystrophy had not been advanced and symptoms had been mild. We previously had given her general anesthesia for two times with nitrous oxide, isoflurane and vecuronium for her to undergo emergency operations, left salpingectomy under laparoscopy due to unruptured tubal pregnancy at 34 years of age and cesarean section due to liver function disorder indicating HELLP syndrome at 36 years of age. Although many problems have been described about the perioperative management in patients with myotonic dystrophy, she was safely managed for each operation.
authors.affiliation: Department of Anesthesiology, Nippon Medical School 2nd Hospital, Kanagawa 211-8533.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Kikutani
authors.forename: Toshiichiroh
authors.initials: T
authors.lastname: Inagi
authors.forename: Kikuzoh
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Yohichi
authors.initials: Y
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D005260:Female; D006801:Humans; D009223:Myotonic Dystrophy / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications