title: [Anesthetic management in a case of myotonic distrophy with dexmedetomidine].
abstract: We encountered a 53-year-old woman with myotonic dystrophy for a total abdominal hysterectomy. In patients with myotonic dystrophy, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management. Combined spinal and epidural block was used in this patient to prevent the occurrence of potential postoperative complications associated with general anesthesia, including respiratory depression. In addition, dexmedetomidine was used for sedation during surgery, because the patient had mental retardation associated with this disease. Airway obstruction was observed after the initial administration of dexmedetomidine at 2 microg x kg(-1) x hr(-1). Therefore, the dose of the drug was reduced to a maintenance dose of 0.2% microg x kg(-1) x hr(-1), resulting in adequate sedation. Dexmedetomidine was proved to be useful in this case; however, use of the drug should be carefully started at a low initial dose in patients with myotonic dystrophy.
authors.affiliation: Department of Anesthesiology, Tokai University School of Medicine, Isehara 259-1193.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Yoshino
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kanazawa
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000402:Airway Obstruction / Q000139:chemically induced / Q000517:prevention & control; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D007044:Hysterectomy; D008607:Intellectual Disability; D008875:Middle Aged; D009223:Myotonic Dystrophy; D011183:Postoperative Complications / Q000517:prevention & control; D012131:Respiratory Insufficiency / Q000517:prevention & control
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine