Bisinotto, Flora Margarida Barra [UNESP]Fabri, Daniel CapucciCalçado, Maida SilvaPerfeito, Paula BorelaTostes, Lucas VieiraSousa, Gabriela Denardi2014-05-272014-05-272010-03-01Revista Brasileira de Anestesiologia, v. 60, n. 2, 2010.0034-70941806-907Xhttp://hdl.handle.net/11449/71589BACKGROUND AND OBJECTIVES: Myotonic dystrophies are autosomal dominant neuromuscular diseases. Among them, myotonic dystrophy type 1 (MD1), or Steinert disease, is the most common in adults, and besides muscular involvement it also has important systemic manifestations. Myotonic dystrophy type 1 poses a challenge to the anesthesiologist. Those patients are more sensitive to anesthetics and prone to cardiac and pulmonary complications. Besides, the possibility of developing malignant hyperthermia and myotonic episodes is also present. CASE REPORT: This is a 39-year old patient with DM1 who underwent general anesthesia for videolaparoscopic cholecystectomy. Total intravenous anesthesia with propofol, remifentanil, and rocuronium was the technique chosen. Intercurrences were not observed in the 90-minute surgical procedure, but after extubation, the patient developed respiratory failure and myotonia, which made tracheal intubation impossible. A laryngeal mask was used, allowing adequate oxygenation, and mechanical ventilation was maintained until full recovery of the respiratory function. The patient did not develop further complications. CONCLUSIONS: Myotonic dystrophy type 1 presents several particularities to the anesthesiologist. Detailed knowledge of its systemic involvement along with the differentiated action of anesthetic drugs in those patients will provide safer anesthetic-surgical procedure.spaComplications, postoperative: respiratory failureDiseases, muscular: myotonic dystrophySurgery, abdominal: cholecystectomyatropinecarbon dioxidecreatine kinasedipyroneketoprofenmetoclopramidemidazolamneostigmineoxygenpropofolranitidineremifentanilrocuroniumtramadolabdominal pressureadductor pollicis muscleadultanesthetic recoveryarterial gasartificial ventilationblood oxygen tensionblood pressure measurementbody temperature monitoringcapnographycase reportcholecystectomycholelithiasisclinical featureconsciousnesscontinuous infusionconvalescencecyanosiselectrocardiogramendotracheal intubationendotracheal tubeextubationfamily historygeneral anesthesiahand muscleheart left ventricle overloadheart repolarizationhemostasishumanintravenous anesthesialaryngeal masklung functionmalemuscle relaxationmyotoniamyotonic dystrophymyotonic dystrophy type 1operation durationoxygenationpatient monitoringpneumoperitoneumpulse oximetryrespiratory failurerespiratory functionscalpelsiblingAdultAnesthesiaCholecystectomy, LaparoscopicHumansMaleMyotonic DystrophyVideo-Assisted SurgeryAnestesia para colecistectomía videolaparoscópica en paciente portador de enfermedad de Steinert. Relato de caso y revisiõn de la literaturaAnesthesia for videolaparoscopic cholecystectomy in a patient with Steinert disease. Case report and review of the literatureArtigo10.1590/S0034-70942010000200011S0034-70942010000200011Acesso aberto2-s2.0-779530594752-s2.0-77953059475.pdf