Ｂｅｃｋｅｒ型筋ジストロフィー症患者に対する完全静脈麻酔法の一経験

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  • Total Intravenous Anesthesia for a Patient with Progressive Muscular Dystrophy.

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We administered total intravenous anesthesia with droperidol, fentanyl and ketamine uneventfully for a patient with Becker's muscular dystrophy who had developed rhabdomyolysis after previous enflurane anesthesia.<br>This patient was a 12-year-old male weighing 44.6kg. A diagnosis of Becker's muscular dystrophy was made when he was 6 years old. At the age of 11, he experienced his first operation for a repair of hypospedias under enflurane-nitrous oxide anesthesia. He developed rhabdomyolysis postoperatively, as substantiated by a marked increase of CPK to 137, 000 unit/e 1, and received diuretic therapy in ICU for 3 days. The second operation was performed when he was 12 under total intravenous anesthesia with droperidol, fentanyl and ketamine without any complication. Neither CPK increase nor myoglobinuria was observed at any time after this anesthesia.<br>Many reports in the literature suggest that some patients with progressive muscular dystrophy may develop malignant hyperpyrexia and malignant hyperpyrexia-like reactions in response to inhaled anesthetics or suxamethonium, but there has been no previous report about such an adverse reaction to intravenous anesthetics. Because we experienced only one patient with progressive muscular dystrophy, we consider this anesthetic method with intravenous agents to be a good choice for patients with neuromuscular disease.

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