Key result
Intravenous infusion of propofol, remifentanil, and atracurium was safe for general anesthesia in a 10-year-old boy with Duchenne muscular dystrophy, without triggering malignant hyperthermia.
Case Report (n=1)
No
Total intravenous anesthesia with propofol, remifentanil, and atracurium appears safe and avoids malignant hyperthermia in a pediatric patient with Duchenne muscular dystrophy.
Supports TIVA safety in pediatric DMD without MH; hypothesis-generating, should not yet change practice.
Duchenne muscular dystrophy (DMD) is an eventually fatal disorder that is characterized by rapidly progressive muscle weakness and atrophy of muscle tissue. The clinical manifestations of DMD vary depending on the stages of the disease. Succinylcholine-induced hyperkalemia and the administration of volatile anesthetic agents, -particularly halothane, -during acute rhabdomyolysis are more likely to result in cardiac arrest and unsuccessful resuscitation in DMD patients than in the general public. This is a case report of a 10-year-old boy who underwent elective strabismus revision under general anesthesia. Anesthesia was induced and maintained with intravenous propofol and remifentanil, which was started at the targeted effect concentration of 3.0g/ml and 3.5 ng/ml respectively via target controlled infusion (TCI). No inhaled anesthetic was used. In addition, an initial dose 0.4 mg/kg of atracurium was injected intravenously over 15s. The results of this case report found intravenous infusion of propofol, remifentanil and atracurium to be safe because the malignant hyperthermia did not occur. (
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Shin et al. (2008) conducted a case report in Duchenne muscular dystrophy (n=1). Total intravenous anesthesia (propofol, remifentanil, atracurium) was evaluated on Safety and occurrence of malignant hyperthermia. Intravenous infusion of propofol, remifentanil, and atracurium was safe for general anesthesia in a 10-year-old boy with Duchenne muscular dystrophy, without triggering malignant hyperthermia.
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