Response to neuromuscular blockade with rocuronium during general anesthesia in a patient with dermatomyositis: A case report
10.17085/apm.2018.13.1.61
- Author:
Sae Yeon KIM
1
;
Yong Bae LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea. sykim@med.yu.ac.kr
- Publication Type:Case Report
- Keywords:
Dermatomyositis;
Pyridostigmine bromide;
Rocuronium bromide
- MeSH:
Anesthesia, General;
Dermatomyositis;
Glycopyrrolate;
Heart Failure;
Humans;
Muscle Weakness;
Muscles;
Myositis;
Neuromuscular Blockade;
Neuromuscular Blocking Agents;
Neuromuscular Monitoring;
Pneumonia, Aspiration;
Pyridostigmine Bromide;
Skin
- From:Anesthesia and Pain Medicine
2018;13(1):61-64
- CountryRepublic of Korea
- Language:English
-
Abstract:
Dermatomyositis is an idiopathic inflammatory myopathy characterized by skin changes and muscle weakness. Depending on the involvement of various muscles, dermatomyositis can cause aspiration pneumonia, ventilatory impairment, and heart failure. Several reports have documented normal or prolonged neuromuscular blockade following administration of different non-depolarizing neuromuscular blockers in patients with dermatomyositis. We observed delayed onset of blockade and prolonged recovery following administration of 0.6 mg/kg rocuronium in a patient with dermatomyositis. However, when the train-of-four ratio reached 0.3, the patient was administered pyridostigmine and glycopyrrolate, which led to normal response to reversal of rocuronium. The patient was extubated without respiratory complications. The outcomes of this case indicate that response to the usual dosage of muscle relaxants in patients with dermatomyositis might be different from that in patients without this condition. Anesthesiologists should pay attention to preoperative cardiorespiratory evaluation and intraoperative neuromuscular monitoring.
