Continuous Infusion Propofol General Anesthesia for Dental Treatment in Patients With Progressive Muscular Dystrophy

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Continuous Infusion Propofol General Anesthesia for Dental Treatment in Patients With Progressive Muscular Dystrophy
Anesthesia Progress
Volume 52, Issue 1 (Spring 2005)

Hiroyoshi Kawaai, DDS, PhD, Kazuho Tanaka, DDS, PhD, Shinya Yamazaki, DDS, PhD
Department of Dental Anesthesiology, Ohu University School of Dentistry, Fukushima, Japan

Progressive muscular dystrophy may produce abnormal reactions to several drugs. There is no consensus of opinion regarding the continuous infusion of propofol in patients with progressive muscular dystrophy. We successfully treated 2 patients with progressive muscular dystrophy who were anesthetized with a continuous infusion of propofol. In case 1, a 19-year-old, 59-kg man with Becker muscular dystrophy and mental retardation was scheduled for dental treatment under general anesthesia. General anesthesia was maintained by a continuous infusion of 6Ò10 mg/kg propofol per hour and an inhalational mixture of 67% nitrous oxide and 33% oxygen. No complications were observed during or after the operation. In case 2, a 5-year-old, 11-kg boy with Fukuyama type congenital muscular dystrophy and slight mental retardation was scheduled for dental treatment under general anesthesia. General anesthesia was maintained with a continuous infusion of 6Ò12 mg/kg propofol per hour and an inhalational mixture of 0.5Ò1.5% sevoflurane in 67% nitrous oxide and 33% oxygen. No complications were observed during or after the operation. It is speculated that a continuous infusion of propofol in progressive muscular dystrophy does not cause malignant hyperthermia because serum levels of creatine phosphokinase and myoglobin decreased after our anesthetic management. Furthermore, our observations suggest that sevoflurane may have some advantages in patients with progressive type muscular dystrophies other than Duchenne muscular dystrophy and Becker muscular dystrophy. In conclusion, our cases suggest that a continuous infusion of propofol for the patients with progressive muscular dystrophy is a safe component of our anesthetic strategy.

Keywords: Propofol, Progressive muscular dystrophy, General anesthesia, Sevoflurane

Received: October 28, 2003; Accepted: July 27, 2004

DOI: 10.2344/0003-3006(2005)52[12:CIPGAF]2.0.CO;2

Address correspondence to Kawaai Hiroyoshi, Department of Dental Anesthesiology, Ohu University School of Dentistry, 31-1 Misumidou, Tomita, Koriyama, Fukushima 963-8611, Japan.

© 2007 The American Dental Society of Anesthesiology