Abstract
Using succinylcholine and inhalation agents for patients with Duchenne muscular dystrophy is extremely risky. Those risks include heart failure, cardiac dysrhythmias, rhabdomyolysis and malignant hyperthermia. Even in emergent situations, such as intraoperative bronchospasm, succinylcholine and inhalational agents are often considered contraindicated. Nevertheless, if intraoperative bronchospasm does occur in a patient with Duchenne muscular dystrophy, the benefits of using inhalational agents to treat bronchospasm may outweigh the risks in certain situations.
Highlights
Duchenne muscular dystrophy (DMD) patients often develop aspiration and inability to clear airway secretions effectively due to respiratory muscle weakness [1]
33 yr old male with PMH of DMD, chronic obstructive pulmonary disease, cardiomyopathy, and gastroesophageal reflex with spontaneously developed supraventricular tachycardia (SVT) and acute respiratory distress presented for emergent intubation
Our case deals with management of acute bronchospasm in a patient susceptible to inhalational agents and depolarizing muscle relaxant
Summary
Duchenne muscular dystrophy (DMD) patients often develop aspiration and inability to clear airway secretions effectively due to respiratory muscle weakness [1]. This quite often leads to pneumonia and further acute respiratory failure requiring emergent intubation. Due to commonly limited mouth opening, neck immobility and cervical spine deformation, DMD patient often present with difficult airway [2]. DMD patients are known for compromised cardiopulmonary function and possible abnormal reactions to succinylcholine and volatile anesthetic agents
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