pancuronium and Myotonic-Dystrophy

In a 57-yr-old female with dystrophia myotonica, attempts to reverse residual non-depolarizing block with neostigmine 1.0 mg were only partially effective and the administration of the further dose (0.5 mg) produced long-lasting muscle weakness. The train-of-four response of this patient resembled that of the depolarizing block and suggested an alteration in the electrical properties of the muscle membrane. A 50-yr-old male with a 30-yr history of progressive muscle dystrophy, exhibited a tonic response to neostigmine in the evoked mechanomyogram during recovery from partial neuromuscular block. It is concluded that the type of reaction to neostigmine in patients with neuromuscular disease in unpredictable.

Topics: Anesthesia, General; Female; Humans; Male; Middle Aged; Muscles; Muscular Dystrophies; Myotonic Dystrophy; Neostigmine; Neuromuscular Junction; Pancuronium

Pancuronium and a continuous infusion of althesin was used to produce muscular relaxation in a patient with myotonic dystrophy. Excellent muscle relaxation with absence of percussion or surgically induced myotonia was obtained but the EMG was not modified; an intracellular site of action of althesin is postulated. Cardiovascular stability was remarkable peroperatively; post-operatively an increased myocardial susceptibility to hypokalaemia was noticed.

Topics: Adult; Alfaxalone Alfadolone Mixture; Anesthesia, General; Electromyography; Female; Fentanyl; Humans; Hysterectomy; Muscle Relaxation; Myotonic Dystrophy; Pancuronium; Preanesthetic Medication

Topics: Anesthetics; Blood Pressure; Drug Combinations; Female; Humans; Hydroxysteroids; Myotonic Dystrophy; Pancuronium; Pentazocine; Pregnanediones

Topics: Anesthesia; Atropine; Cholinesterases; Electromyography; Halothane; Humans; Male; Melanoma; Middle Aged; Muscular Diseases; Myotonia; Myotonia Congenita; Myotonic Dystrophy; Neoplasms; Neostigmine; Pancuronium; Preanesthetic Medication; Spectrophotometry; Succinylcholine; Temperature; Time Factors