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Caudal epidural block instead of general anesthesia in an adult with Duchenne muscular dystrophy

Authors Shafy SZ, Hakim M, Arce Villalobos M, Pearson GD, Veneziano G, Tobias JD

Received 20 July 2018

Accepted for publication 21 August 2018

Published 15 October 2018 Volume 2018:11 Pages 75—80

DOI https://doi.org/10.2147/LRA.S180867

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 4

Editor who approved publication: Dr Stefan Wirz


Shabana Z Shafy,1 Mohammed Hakim,1 Mauricio Arce Villalobos,1 Gregory D Pearson,2,3 Giorgio Veneziano,1 Joseph D Tobias1,4

1Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 2Department of Plastic Surgery, Nationwide Children’s Hospital, Columbus, OH, USA; 3Department of Plastic Surgery, The Ohio State University, Columbus, Ohio, USA; 4Department of Anesthesiology & Pain Medicine, The Ohio State University, Columbus, Ohio, USA

Abstract: Duchenne muscular dystrophy (DMD), first described in 1834, is an X-linked dystrophinopathy, leading to early onset skeletal muscle weakness. Life expectancy is reduced to early adulthood as a result of involvement of voluntary skeletal muscles with respiratory failure, orthopedic deformities, and associated cardiomyopathy. Given its multisystem involvement, surgical intervention may be required to address the sequelae of the disease process. We present a 36-year-old adult with DMD, who required anesthetic care during surgical debridement of an ischial pressure sore. Given his significant respiratory muscle involvement, ultrasound-guided caudal epidural anesthesia was used instead of general during the surgical procedure. The technique and its applications are discussed, with particular emphasis on the feasibility and safety of using regional anesthetic techniques in patients with DMD.

Keywords: Duchenne’s muscular dystrophy, caudal epidural, regional anesthesia

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