The ultrasound-guided nerve blocks of abdominal wall contributed to anesthetic management of cholecystectomy in a patient with Becker muscular dystrophy without using muscle relaxants

• Published in: JA clinical reports Vol. 3; no. 1; p. 64
• Main Authors: Iwata, Masato, Kuzumoto, Naoya, Akasaki, Yuka, Morioka, Masayo, Nakayama, Kana, Matsuzawa, Nobuyoshi, Kimoto, Katsuhiro, Shimomura, Toshiyuki
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 08.12.2017; Springer Nature B.V; SpringerOpen
• Subjects: Anesthesia; Anesthesiology; Becker muscular dystrophy; Case Report; Cholecystectomy; Critical Care Medicine; Emergency Medicine; Intensive; Medicine; Medicine & Public Health; Muscular dystrophy; Pain Medicine; Rectus sheath block; Total intravenous anesthesia; Ultrasonic imaging; Becker muscular dystrophy; Rectus sheath block; Total intravenous anesthesia
• ISSN: 2363-9024; 2363-9024
• DOI: 10.1186/s40981-017-0134-1

Becker muscular dystrophy (BMD) is a progressive neuromuscular disorder caused by mutations in the dystrophin gene. The sensitivity to non-depolarizing muscle relaxant in a patient with muscle dystrophy is reportedly higher than that in normal individuals, and the duration of the effect is known to be prolonged. In this report, we present the case of a 58-year-old man with BMD who underwent laparoscopic cholecystectomy for symptomatic cholelithiasis under total intravenous anesthesia without the use of muscle-relaxant drugs and supplemented with regional anesthesia. Anesthesia was induced and maintained with propofol, remifentanil, and fentanyl; ultrasound-guided bilateral rectus sheath block (RSB) and right-sided subcostal transversus abdominis plane block (TAP) were performed. The procedure required conversion to open surgery because of hard conglutination; intraoperative and postoperative periods were uneventful. Adequate analgesia was maintained after extubation because of the effect of RSB and TAP.