Peng Ling, Wei Wei
Department of Anaesthesiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Clin Cases. 2021 Oct 16;9(29):8852-8857. doi: 10.12998/wjcc.v9.i29.8852.
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.
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.
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.
贝克肌营养不良症（BMD）患者在接触挥发性麻醉剂和去极化肌松剂时，发生高钾血症、横纹肌溶解和恶性高热的风险很高。BMD患者在全身麻醉后也容易出现呼吸抑制。因此，麻醉医生对BMD患者进行麻醉管理极具挑战性，尤其是小儿BMD患者。在此，我们报告了在一名接受腹腔镜腹股沟疝修补术的小儿BMD患者中，使用腹横肌平面阻滞（TAPB）联合全静脉麻醉（TIVA）成功进行麻醉管理的案例。
一名2岁男孩，体重15kg，患有BMD，计划进行腹腔镜腹股沟疝修补术。诱导采用TIVA，麻醉维持采用短效静脉麻醉剂持续输注联合TAPB。此外，TAPB提供了良好的术后镇痛效果。患者手术和麻醉过程顺利，在17个月的随访期内未出现麻醉相关并发症。
TAPB联合TIVA，使用短效静脉麻醉剂，可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。
