Punt-van Manen J A, Müller H, Kalenda Z
Anaesthesist. 1984 Aug;33(8):348-55.
The dangers associated with anaesthesia and postoperative care in patients with dystrophia myotonica are reviewed. Weakness, atrophy and myotonia of the respiratory muscles and abnormal drug responses are among the many features of the disease which create specific problems. Capnography is obviously a monitor of particular value, yet capnograms in dystrophia myotonia patients have never been published. Abnormal capnograms recorded in a patient with dystrophia myotonica before and after the administration of neostigmine are described. A technique of anaesthetic management avoiding drug liable to produce abnormal reactions, and with the capnogram as a guide, is discussed.
回顾了强直性肌营养不良患者麻醉及术后护理相关的风险。呼吸肌无力、萎缩和肌强直以及异常的药物反应是该疾病诸多特征中的一部分,这些特征会引发特定问题。二氧化碳图显然是一种具有特殊价值的监测手段,但强直性肌营养不良患者的二氧化碳图从未见诸报道。本文描述了一名强直性肌营养不良患者在使用新斯的明前后记录到的异常二氧化碳图。讨论了一种麻醉管理技术,该技术避免使用易产生异常反应的药物,并以二氧化碳图作为指导。