Anesthetic management of a myotonic dystrophy patient with paraganglionoma.
Myotonic dystrophy (DM), though rare, can significantly complicate anesthesia due to muscular and extra-muscular involvement. When this condition is compounded by a pheochromocytoma, anesthetizing such patients becomes extra challenging. We present a case report of a 61-year-old lady with congenital DM, with the whole gamut of associated features, was diagnosed with a noradrenaline secreting paraganglionoma following investigation of refractory hypertension. We anesthetized her for an open resection of the lesion. The conduct of anesthesia and recovery of this patient is described. Our experience suggests that anesthetizing these patients though challenging can be safely managed with relaxant general anesthesia and epidural analgesia with meticulous care pre, intra and post-surgical intervention.
Monash University, Clayton, Victoria, Australia; Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia.
Ashwin
A
Subramaniam
Box Hill Hospital, Eastern Health, Box Hill, Victoria, Australia.
Robert
R
Grauer
Box Hill Hospital, Eastern Health, Box Hill, Victoria, Australia.
David
D
Beilby
Monash University, Clayton, Victoria, Australia; Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia. Electronic address: travindranath@hotmail.com.
Ravindranath
R
Tiruvoipati
D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000767:Anesthesia, Epidural; D000768:Anesthesia, General / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002395:Catecholamines / Q000097:blood / Q000652:urine; D003329:Coronary Vasospasm / Q000188:drug therapy* / Q000209:etiology / Q000652:urine; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology / Q000652:urine; D008875:Middle Aged; D009223:Myotonic Dystrophy / Q000150:complications*; D010235:Paraganglioma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019990:Perioperative Care; D010643:Phenoxybenzamine / Q000627:therapeutic use; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011433:Propranolol / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D002395:Catecholamines; D010643:Phenoxybenzamine; D011433:Propranolol
Myotonic dystrophy; dystrophia myotonica; general anesthesia; hypertension; paraganglionoma; pheochromocytoma