Kaufmann in 1960 first recognised that patients with dystrophia myotonica had an unexpectedly high perioperative morbidity and mortality, caused primarily by cardiorespiratory complications) Patients with the disease frequently present for removal of cataracts, correction of anterior open bite and cholecystectomy.Anaesthesia is often complicated for several reasons. Preoperatively, as well as having specific problems with muscle wasting, weakness, myotonia and contractures, there is evidence of generalised involvement of the cardiac, respiratory, neurological and endocrine systems. 2These patients are especially sensitive to respiratory depressants 3 and often have an abnormal response to both the depolarizing and competitive neuromuscular blocking d~gs. 4In the immediate postoperative period anticholinesterases s and shivering 6 can initiate myotonic contractions.

Propofol has many advantages as an anaesthetic induction agent and onc of its attractions is the low incidence of allcrgic reactions1 but this is a report of a case in which signs of local histamine release occurred after injection of prop o fo I.A 33-year-old man presented for outpatient cystoscopy.He was fit and had no specific allergies although he suffered Cram mild summer hay fever. A 20-gauge cannula (Vcnflon) was sited in a vein in the incidence varies the site of injection.' There have bccn sonic rcports of erythema. nun-specific rashes and phle-bitis1-3 but 1 am unaware of any previous reports of weals which may indicate local histamine release.Glmgoii, Royal Infirrncirj, Glusgow G31 ZER