Anaesthetic Management in Duchenne Muscular Dystrophy Patient with TIVA Using Combination of Propofol and Dexmedetomidine Complimented with USG Guided ESPB Block- A Case Report

Jyoti Deshpande; Pritam Chavan; Merlin Elizabeth Jacob

doi:10.18502/aacc.v8i3.9620

Jyoti Deshpande Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, India.
Pritam Chavan Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, India.
Merlin Elizabeth Jacob Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, India.

DOI: https://doi.org/10.18502/aacc.v8i3.9620

Keywords: Duchenne muscular dystrophy (DMD); Total intravenous anesthesia (TIVA); Erector spinae plane block (ESPB)

Abstract

Muscular dystrophies are a group of genetic diseases which cause progressive degeneration of skeletal muscle along with weakness. They are characterized by an impaired synthesis or regeneration of contractile protein. Patients with muscular dystrophies possess high preoperative risk with significant anaesthetic implications (hyperkalaemia, rhabdomyolysis, cardiovascular instability, sudden death, etc.). We herein describe the anaesthetic management of a 31yr old male who was a known case of Duchenne muscular dystrophy posted for right percutaneous nephrolithotomy (PCNL). The patient was induced and maintained with TIVA and using nitrous oxide as the only inhalational agent supplemented with USG guided Erector spinae plane block (ESPB) for post-operative analgesia. A thorough preoperative evaluation and multidisciplinary approach is essential for perioperative management of such cases.