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Use of remifentanil and propofol without muscle relaxant with Duchenne muscular dystrophy - A case report -
Anesth Pain Med 2018;13(1):30-3
Published online January 31, 2018
© 2018 Korean Society of Anesthesiologists.

Heung Soo Kim, Seung Youp Baek, Dong Ho Park, and Keon Hee Ryu
Department of Anesthesiology and Pain Medicine, Eulji University Hospital, Daejeon, Korea
Correspondence to: Keon Hee Ryu, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, Eulji University Hospital, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Korea
Tel: 82-42-611-3883
Fax: 82-42-611-3882
Received May 31, 2017; Revised September 25, 2017; Accepted September 26, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Duchenne muscular dystrophy (DMD) is a relatively rare muscle disease with severe symptoms. Owing to the commonly limited mouth opening, cervical spine immobility, and deformation, DMD patients often present with a difficult airway. Patients with DMD are sensitive to sedation, anesthesia, and neuromuscular blockade. This risk increases as the disease progresses with age. The anesthetic management of these patients can cause various issues, presenting a challenge to anesthesiologists. We administered anesthesia for an orchiectomy in a patient with testicular cancer using total intravenous anesthesia with propofol and remifentanil without muscle relaxants. Although the patient was Mallampati grade IV due to neck stiffness, tracheal intubation was successfully performed with a portable videolaryngoscope. The intraoperative course was uneventful and recovery was rapid without postoperative complications. In conclusion, anesthesia without a muscle relaxant was successful and the patient recovered rapidly, even with a difficult tracheal intubation.
Key Words : Airway management, Duchenne muscular dystrophy, Intravenous anesthesia, Neuromuscular blocking agents.

January 2018, 13 (1)
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