Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1016/j.bjane.2021.07.037
Brazilian Journal of Anesthesiology
Case Report

Several challenges associated with the anesthetic management of Emery-Dreifuss muscular dystrophy patients: case report

Distrofia muscular de Emery-Dreifuss: múltiplos problemas na abordagem anestésica: relato de um caso

Ana Isabel Leite, Sofia da Silva Ramos, Raquel Inácio, Isabel Rute Vilhena, Joana Carvalhas

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Abstract

Emery-Dreifuss Muscular Dystrophy is a very rare type of muscular dystrophy, associated with contractures, atrophy and muscle weakness, besides cardiomyopathy with severe arrhythmias. Published studies focusing on this disorder are scarce. We describe the anesthetic management of a male patient with Emery-Dreifuss Muscular Dystrophy, to be submitted to umbilical and inguinal hernioplasty and hydrocele repair under epidural anesthesia. The anesthesia approach enabled us to circumvent the patient’s susceptibility to malignant hyperthermia and his potentially difficult airway, in addition to maintaining hemodynamic stability. The day after surgery the patient resumed walking, and two days later he was discharged from the hospital.

Keywords

Emery-Dreifuss muscular dystrophy;  Epidural anesthesia;  Malignant hyperthermia;  Airway management; Case report

Resumo

A Distrofia Muscular de Emery-Dreifuss é uma forma muito rara de distrofia muscular, associada a contraturas, atrofia e fraqueza muscular, bem como a cardiomiopatia condicionando arritmias severas. A literatura científica acerca dessa doença é muitíssimo escassa. Descrevemos o caso de um doente do sexo masculino diagnosticado com essa patologia, proposto para hernioplastias umbilical e inguinal e correção de hidrocele sob bloqueio epidural. O plano anestésico permitiu contornar a suscetibilidade à hipertermia maligna e a via área potencialmente difícil, bem como preservar a estabilidade hemodinâmica. O doente retomou a marcha no dia seguinte à cirurgia e teve alta dois dias depois.

Palavras-chave

Distrofia Muscular de Emery-Dreifuss; Anestesia epidural; hipertermia maligna; manuseio das vias aéreas; Relato de caso

References

1. Aldwinckle Rj, Carr As. The anesthetic management of a patient with Emery-Dreifuss muscular dystrophy for orthopedic surgery. Can J Anesth. 2002;49:467-70.

2. Voit T, Krogmann O, Lenard HG, et al. Emery-Dreifuss muscular dystrophy: disease spectrum and differential diagnosis. Neuro- pediatrics. 1988;19:62-71.

3. Shende D, Agarwal R. Anaesthetic management of a patient with Emery-Dreifuss muscular dystrophy. Anaesth Intensive Care. 2002;30:372-5.

4. Kim OM, Elliott D. Elective caesarean section for a woman with Emery-Dreifuss muscular dystrophy. Anaesth Intensive Care. 2010;38:744-7.

5. Morrison P, Jago RH. Emery-Dreifuss muscular dystrophy. Anaesthesia. 1991;46:33-5.


Submitted date:
02/08/2021

Accepted date:
07/03/2021

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Braz J Anesthesiol

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