title: Anesthesia for laparoscopic surgery in a patient with myotonic dystrophy (Steinert's disease): beneficial use of sugammadex, but incorrect use of pethidine: a case report.
abstract: Patients with Myotonic Dystrophy show an unpredictable response to several anesthetic drugs including opioids, neuromuscular blocking agents and especially reversal agents like neostigmine. We describe the case of a 40 year old patient with myotonic dystrophy who underwent laparoscopic cholecystectomy and ovarian cyst removal under general anesthesia. The authors suggest the use of the new reversal agent suggamadex, for reversing neuromuscular blockade caused by rocuronium, in patients suffering from neuromuscular disease and especially from Myotonic Dystrophy, because it rapidly and completely reverses any residual neuromuscular blockade, but also underline the increased susceptibility of these patients to opioids.
authors.affiliation: Anesthesiology Department, Hatzikosta General Hospital, Ioannina, Greece. voulam@otenet.gr
authors.forename: P
authors.initials: P
authors.lastname: Mavridou
authors.forename: V
authors.initials: V
authors.lastname: Dimitriou
authors.forename: A
authors.initials: A
authors.lastname: Margaritis
authors.forename: A
authors.initials: A
authors.lastname: Manataki
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000732:Androstanols / Q000037:antagonists & inhibitors; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008614:Meperidine / Q000009:adverse effects*; D009223:Myotonic Dystrophy / Q000601:surgery*; D009270:Naloxone / Q000008:administration & dosage; D009292:Narcotic Antagonists / Q000008:administration & dosage; D019148:Neuromuscular Blockade / Q000379:methods; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors*; D010048:Ovarian Cysts / Q000601:surgery; D010149:Postoperative Pain / Q000188:drug therapy; D012131:Respiratory Insufficiency / Q000139:chemically induced; D000077123:Rocuronium; D000077122:Sugammadex; D047408:gamma-Cyclodextrins
chemical_list: D000701:Analgesics, Opioid; D000732:Androstanols; D009292:Narcotic Antagonists; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D009270:Naloxone; D008614:Meperidine; D000077123:Rocuronium