Abstract
症例は64歳,男性.主訴は血便.入院後,注腸,大腸内視鏡検査で横行結腸癌と診断した.54歳時に白内障の手術を受けており,前頭部の脱毛,両眼瞼の下垂,顔筋,前頸筋の筋力低下,grip myotonia, percussion myotonia,遠位筋を主とする筋萎縮,筋硬直など筋緊張性ジストロフィーに特徴的な所見を呈していた.手術は,無挿管の硬膜外麻酔で筋弛緩剤は使用せずに施行したがとくに問題はなかった.術後も呼吸抑制,肺合併症もなく経過し第60病日に退院した.本症患者の手術では,術前の心筋障害,呼吸機能の評価麻酔法の選択,そして術後の厳重な呼吸管理が必要であると考えられた.
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