Kim Ji Eun, Chun Hea Rim
Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, Dongnam-gu, Cheonan, Chungcheongnam-do, Korea.
Medicine (Baltimore). 2017 Mar;96(13):e6456. doi: 10.1097/MD.0000000000006456.
Anesthetic management of patients with Duchenne muscular dystrophy (DMD) is complicated because these patients are more sensitive to nondepolarizing neuromuscular blocking agents (NMBAs) and are vulnerable to postoperative complications, such as postoperative residual curarization and respiratory failure. Sugammadex is a new reversal agent for aminosteroidal NMBAs, but its safety in children is controversial.
An 11-year-old boy with DMD underwent general anesthesia for a percutaneous nephrolithotomy. We used rocuronium bromide and sugammadex to reverse the deep neuromuscular block. Reversal of neuromuscular block was done 15 minutes after administration of 2 mg/kg of sugammadex. The patient's recovery from anesthesia was uneventful, and he was discharged to the postoperative recovery ward.
A delayed recovery was achieved, but no adverse events were observed, such as recurarization or hypersensitivity to sugammadex. We report safe use of 2 mg/kg of sugammadex to reverse a deep neuromuscular block in a child with DMD.
杜氏肌营养不良症（DMD）患者的麻醉管理较为复杂，因为这些患者对非去极化神经肌肉阻滞剂（NMBAs）更为敏感，且易发生术后并发症，如术后残余肌松和呼吸衰竭。舒更葡糖钠是一种新型的氨基甾体类NMBAs逆转剂，但其在儿童中的安全性存在争议。
一名11岁的DMD男孩接受了经皮肾镜取石术的全身麻醉。我们使用了罗库溴铵和舒更葡糖钠来逆转深度神经肌肉阻滞。在给予2mg/kg舒更葡糖钠15分钟后进行神经肌肉阻滞的逆转。患者麻醉恢复顺利，随后被转入术后恢复病房。
实现了延迟恢复，但未观察到不良事件，如再次出现肌松或对舒更葡糖钠过敏。我们报告了在一名DMD儿童中安全使用2mg/kg舒更葡糖钠逆转深度神经肌肉阻滞的情况。
