Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2021; 9(29): 8852-8857
Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8852
Anesthesia management in a pediatric patient with Becker muscular dystrophy undergoing laparoscopic surgery: A case report
Ling Peng, Wei Wei
Ling Peng, Wei Wei, Department of Anaesthesiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Peng L drafted the manuscript; Wei W supervised the writing of the manuscript; both authors participated in the management of the patient in this case report, and read and approved the manuscript.
Informed consent statement: Informed written consent was obtained from the patient’s father for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) statement, and the manuscript was prepared and revised according to the CARE Checklist (2016) statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Wei, MD, Chief Doctor, Department of Anaesthesiology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. weiw@scu.edu.cn
Received: May 18, 2021
Peer-review started: May 18, 2021
First decision: June 15, 2021
Revised: June 22, 2021
Accepted: August 9, 2021
Article in press: August 9, 2021
Published online: October 16, 2021
Processing time: 150 Days and 7.4 Hours
Abstract
BACKGROUND

Patients with Becker muscular dystrophy (BMD) have a high risk of developing hyperkalemia, rhabdomyolysis, and malignant hyperthermia when exposed to volatile anesthetics and depolarizing muscle relaxants. Patients with BMD are also prone to respiratory depression after general anesthesia. Thus, it is extremely challenging for anesthesiologists to manage anesthesia in BMD patients, particularly in pediatric BMD patients. Here, we present successful anesthesia management using transversus abdominis plane block (TAPB) combined with total intravenous anesthesia (TIVA) in a pediatric BMD patient undergoing laparoscopic inguinal hernia repair.

CASE SUMMARY

A 2-year-old boy, weighing 15 kg, with BMD, was scheduled for laparoscopic inguinal hernia repair. TIVA was used for induction, and continuous infusions of short-acting intravenous anesthetics combined with TAPB were performed for anesthesia maintenance. Moreover, TAPB provided good postoperative analgesia. The patient underwent uneventful surgery and anesthesia, and over the 17 mo follow-up period showed no anesthesia-induced complications.

CONCLUSION

TAPB combined with TIVA, using short-acting intravenous anesthetic agents, can provide safe and effective anesthesia management in pediatric BMD patients undergoing short-term abdominal surgery.

Keywords: Transversus abdominis plane block; Total intravenous anesthesia; Becker muscular dystrophy; Pediatric patient; Case report

Core Tip: Becker muscular dystrophy (BMD) is a rare disease induced by genetic mutations. Anesthesia management is extremely challenging in patients with BMD, as they are at high risk of developing hyperkalemia, rhabdomyolysis, or malignant hyperthermia. The mortality rate is very high in patients with these complications. In this report, we describe the use of total intravenous anesthesia combined with transversus abdominis plane block for laparoscopic inguinal hernia repair in a pediatric patient with BMD. This anesthesia technique is considered a safe and effective strategy for pediatric BMD patients. Our pediatric BMD patient achieved a good outcome.