Case Report: General Anesthetic Management for Laparoscopic Cholecystectomy in Paramyotonia Congenita

Authors

  • Analise McGreal Mercer University School of Medicine, Macon, Georgia, United States.
  • Daniel Slagle Mercer University School of Medicine, Macon, Georgia, United States.
  • Andrew Dickens Anesthesia Associates of Columbus. Emory-St. Francis Hospital in Columbus, Georgia, United States.

DOI:

https://doi.org/10.5195/ijms.2020.604

Keywords:

Anesthesia, Paramyotonia congenita, Laparoscopic cholecystectomy, General anesthesia, Sodium channel muscle disorders

Abstract

Background: Paramyotonia congenita (PC) is a rare disorder affecting skeletal muscle. Patients with this non-progressive condition experience intermittent episodes of sustained myotonia. Due to the predisposition for prolonged muscle contraction, special attention must be given to anesthetic management during operative procedures to prevent complications similar to those experienced in patients with malignant hyperthermia. To date, however, limited reports of anesthetic management in paramyotonia congenita are available.

The Case: The present report describes successful general anesthetic management given to a patient with paramyotonia congenita using propofol and ketamine for induction, non-depolarizing rocuronium for muscle paralysis, and continuous nitrous oxide and IV propofol infusion for sedation. The patient remained stable throughout the case without myotonic episodes or other complications.

Conclusion: Our report describes successful anesthetic management in a patient with paramyotonia congenita. This provides a potential management plan that may be applied to PC patients undergoing a variety of surgical procedures and eliminates risk associated with succinylcholine and possibly volatile anesthetics. Further research is needed to determine whether this approach is superior to previously reported techniques and should also identify which agents may be effectively utilized to reverse an intra-operative myotonic episode in PC.

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Author Biographies

Analise McGreal, Mercer University School of Medicine, Macon, Georgia, United States.

Analise McGreal is a third year medical student at Mercer University School of Medicine in Columbus, GA. She is a member of the Alpha Omega Alpha Honor Medical Society. She plans to pursue training in internal medicine.

Daniel Slagle, Mercer University School of Medicine, Macon, Georgia, United States.

Third-year Medical Student.

Andrew Dickens, Anesthesia Associates of Columbus. Emory-St. Francis Hospital in Columbus, Georgia, United States.

MD, Staff anesthesiologist

References

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Published

2020-12-09

How to Cite

McGreal, A., Slagle, D., & Dickens, A. (2020). Case Report: General Anesthetic Management for Laparoscopic Cholecystectomy in Paramyotonia Congenita. International Journal of Medical Students, 8(3), 288–290. https://doi.org/10.5195/ijms.2020.604

Issue

Vol. 8 No. 3 (2020)

Section

Case Report

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