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[Combined spinal-epidural anesthesia for cesarean section in a parturient with myotonic dystrophy].
Masui. 2010 Aug; 59(8):1000-3.M

Abstract

Myotonic dystrophy (MD) is a muscle disorder characterized by progressive muscle wasting and weakness, and is the most common form of muscular dystrophy that begins in adulthood, often after pregnancy. MD might be related to occurrence of malignant hyperthermia. Therefore, the cesarean section is often performed for the parturient with MD. We had an experience of combined spinal-epidural anesthesia for cesarean section in a parturient complicated with MD. A 40-year-old woman had rhabdomyolysis caused by ritodrine at 15-week gestation and was diagnosed as MD by electromyography. Her first baby died due to respiratory failure fourth day after birth. She had hatchet face, slight weakness of her lower extremities, and easy fatigability. Her manual muscle test was 5/5 at upper extremities and 4/5 at lower extremities. She underwent emergency cesarean section for premature rupture of the membrane, weak pain during labor, and obstructed labor at 33-week gestation. We placed an epidural catheter from T12/L1 and punctured arachnoid with 25 G spinal needle. We performed spinal anesthesia using 0.5% hyperbaric bupivacaine 1.5 ml and epidural anesthesia using 2% lidocaine 6 ml. Her anesthetic level reached bilaterally to T7 and operation started 18 minutes after combined spinal-epidural anesthesia. Her baby was born 23 minutes after the anesthesia. As her baby was 1/5 at Apgar score, the baby was tracheally intubated and artificially ventilated. The cesarean section was finished in 33 minutes uneventfully. She had no adverse events and was discharged on the 8th postoperative day. Later her baby was diagnosed as congenital MD by gene analysis. Combined spinal-epidural anesthesia with the amide-typed local anesthetic agents could be useful and safe for cesarean section in the parturient with MD.

Authors+Show Affiliations

Department of Anesthesiology, Teikyo University School of Medicine, Tokyo.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

20715526

Citation

Mori, Kosuke, et al. "[Combined Spinal-epidural Anesthesia for Cesarean Section in a Parturient With Myotonic Dystrophy]." Masui. the Japanese Journal of Anesthesiology, vol. 59, no. 8, 2010, pp. 1000-3.
Mori K, Mizuno J, Nagaoka T, et al. [Combined spinal-epidural anesthesia for cesarean section in a parturient with myotonic dystrophy]. Masui. 2010;59(8):1000-3.
Mori, K., Mizuno, J., Nagaoka, T., Harashima, T., & Morita, S. (2010). [Combined spinal-epidural anesthesia for cesarean section in a parturient with myotonic dystrophy]. Masui. the Japanese Journal of Anesthesiology, 59(8), 1000-3.
Mori K, et al. [Combined Spinal-epidural Anesthesia for Cesarean Section in a Parturient With Myotonic Dystrophy]. Masui. 2010;59(8):1000-3. PubMed PMID: 20715526.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Combined spinal-epidural anesthesia for cesarean section in a parturient with myotonic dystrophy]. AU - Mori,Kosuke, AU - Mizuno,Ju, AU - Nagaoka,Takehiko, AU - Harashima,Toshiya, AU - Morita,Sigeho, PY - 2010/8/19/entrez PY - 2010/8/19/pubmed PY - 2010/9/24/medline SP - 1000 EP - 3 JF - Masui. The Japanese journal of anesthesiology JO - Masui VL - 59 IS - 8 N2 - Myotonic dystrophy (MD) is a muscle disorder characterized by progressive muscle wasting and weakness, and is the most common form of muscular dystrophy that begins in adulthood, often after pregnancy. MD might be related to occurrence of malignant hyperthermia. Therefore, the cesarean section is often performed for the parturient with MD. We had an experience of combined spinal-epidural anesthesia for cesarean section in a parturient complicated with MD. A 40-year-old woman had rhabdomyolysis caused by ritodrine at 15-week gestation and was diagnosed as MD by electromyography. Her first baby died due to respiratory failure fourth day after birth. She had hatchet face, slight weakness of her lower extremities, and easy fatigability. Her manual muscle test was 5/5 at upper extremities and 4/5 at lower extremities. She underwent emergency cesarean section for premature rupture of the membrane, weak pain during labor, and obstructed labor at 33-week gestation. We placed an epidural catheter from T12/L1 and punctured arachnoid with 25 G spinal needle. We performed spinal anesthesia using 0.5% hyperbaric bupivacaine 1.5 ml and epidural anesthesia using 2% lidocaine 6 ml. Her anesthetic level reached bilaterally to T7 and operation started 18 minutes after combined spinal-epidural anesthesia. Her baby was born 23 minutes after the anesthesia. As her baby was 1/5 at Apgar score, the baby was tracheally intubated and artificially ventilated. The cesarean section was finished in 33 minutes uneventfully. She had no adverse events and was discharged on the 8th postoperative day. Later her baby was diagnosed as congenital MD by gene analysis. Combined spinal-epidural anesthesia with the amide-typed local anesthetic agents could be useful and safe for cesarean section in the parturient with MD. SN - 0021-4892 UR - https://www.unboundmedicine.com/medline/citation/20715526/[Combined_spinal_epidural_anesthesia_for_cesarean_section_in_a_parturient_with_myotonic_dystrophy]_ L2 - http://www.diseaseinfosearch.org/result/5076 DB - PRIME DP - Unbound Medicine ER -