Postoperative complications of dystrophia myotonica

A 44-year-old man with known mitral stenosis presented for minor surgery. Anaesthesia was induced with fentanyl, droperidol and etomidate and maintained with nitrous oxide, oxygen and vecuronium. Surgery and anaesthesia were uneventful but the postoperative course was stormy, with respiratory arrest, Haemophilus pneumonia, refractory cardiac dysrhythmias and gastrointestinal atony. A diagnosis of dystrophia myotonica was made after 3 weeks in the intensive care unit, and he spent 6 weeks in hospital. A high index of suspicion for this disease must be maintained and intensive care facilities and monitoring should be available for all procedures.