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Response to neuromuscular blockade with rocuronium during general anesthesia in a patient with dermatomyositis - A case report -
Anesth Pain Med 2018;13(1):61-4
Published online January 31, 2018
© 2018 Korean Society of Anesthesiologists.

Sae Yeon Kim and Yong Bae Lee
Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea
Correspondence to: Sae Yeon Kim, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea
Tel: 82-53-620-3363
Fax: 82-53-626-5275
E-mail: sykim@med.yu.ac.kr
ORCID
http://orcid.org/0000-0002-7329-2791
Received June 12, 2017; Revised July 16, 2017; Accepted July 21, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Key Words : Dermatomyositis, Pyridostigmine bromide, Rocuronium bromide.


January 2018, 13 (1)
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