Abstract:
BACKGROUND: Patients with Becker muscular dystrophy (BMD) have a high risk of developing hyperkalemia, rhabdomyolysis, and malignant hyperthermia when exposed to volatile anesthetics and depolarizing muscle relaxants. Patients with BMD are also prone to respiratory depression after general anesthesia. Thus, it is extremely challenging for anesthesiologists to manage anesthesia in BMD patients, particularly in pediatric BMD patients. Here, we present successful anesthesia management using transversus abdominis plane block (TAPB) combined with total intravenous anesthesia (TIVA) in a pediatric BMD patient undergoing laparoscopic inguinal hernia repair.
METHODS: A 2-year-old boy, weighing 15 kg, with BMD, was scheduled for laparoscopic inguinal hernia repair. TIVA was used for induction, and continuous infusions of short-acting intravenous anesthetics combined with TAPB were performed for anesthesia maintenance. Moreover, TAPB provided good postoperative analgesia. The patient underwent uneventful surgery and anesthesia, and over the 17 mo follow-up period showed no anesthesia-induced complications.
CONCLUSIONS: TAPB combined with TIVA, using short-acting intravenous anesthetic agents, can provide safe and effective anesthesia management in pediatric BMD patients undergoing short-term abdominal surgery.
摘要:
背景:贝克尔肌营养不良(BMD)患者发生高钾血症的风险很高,横纹肌溶解症,和恶性高热暴露于挥发性麻醉剂和去极化肌肉松弛剂时。BMD患者在全身麻醉后也容易出现呼吸抑制。因此,麻醉医师对BMD患者的麻醉管理极具挑战性,尤其是儿科BMD患者。这里,我们介绍了1例接受腹腔镜腹股沟疝修补术的小儿BMD患者采用腹横肌平面阻滞(TAPB)联合全静脉麻醉(TIVA)的成功麻醉管理.
方法:一个2岁的男孩,体重15公斤,BMD,计划进行腹腔镜腹股沟疝修补术。TIVA用于诱导,并连续输注短效静脉麻醉药联合TAPB进行麻醉维持。此外,TAPB提供了良好的术后镇痛效果。病人接受了顺利的手术和麻醉,在17个月的随访期间,没有麻醉引起的并发症。
结论:TAPB联合TIVA,使用短效静脉麻醉剂,可以为接受短期腹部手术的小儿BMD患者提供安全有效的麻醉管理。