Case report: anaesthesia in myotonic dystrophy

Pancuronium and a continuous infusion of althesin was used to produce muscular relaxation in a patient with myotonic dystrophy. Excellent muscle relaxation with absence of percussion or surgically induced myotonia was obtained but the EMG was not modified; an intracellular site of action of althesin is postulated. Cardiovascular stability was remarkable peroperatively; post-operatively an increased myocardial susceptibility to hypokalaemia was noticed.