Key wordsComplications; myotonia dystrophica.Myotonic dystrophy is a multisystem disease requiring the skill and knowledge of the anaesthetist in dealing with organ dysfunction and unique drug responses. Intraoperative problems have received considerable attention in the literature; however, the postoperative period is also hazardous and the care during this time has been under-emphasised. An illustrative case is presented to demonstrate the need for the involvement of the anaesthetist during the preand postoperative periods.
Case historyThe patient, a 32-year-old white male, presented for evaluation of a mediastinal mass.He had myotonic dystrophy from the age of 17 and at admission he presented with the classical features ( Fig. 1): frontal baldness, ptosis, lenticular opacities, expressionless face, wasted sternocleidomastoids, peripheral muscle weakness, areflexia of the limbs, testicular atrophy and dysphagia. His father and one brother also have myotonic dystrophy. He had smoked 20 cigarettes a day for 15 years but denied frequent respiratory infections or chronic bronchitis. The patient had an uneventful tonsillectomy under general anaesthesia in childhood, and recently had viral pericarditis complicated by a pericardial effusion and dysrhythmias.On examination his weight was 66 kg, blood pressure 134/70 mmHg, pulse 68 and regular.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.