[Postoperative continuous epidural infusion of morphine in a patient with myotonic dystrophy]

Patients with myotonic dystrophy present potential problems during and after anesthesia, especially respiratory dysfunction. A 42-year-old female with myotonic dystrophy associated with slight impairment of respiratory functions and muscular power, underwent abdominal total hysterectomy under epidural anesthesia uneventfully. To relieve pain after the surgery, a bolus of epidural morphine 2 mg was administered through an indwelling lumbar (L1-2) epidural catheter 30 minutes prior to the end of the surgery and followed with continuous epidural infusion of morphine at a rate of 0.083 mg.h-1 using a balloon (Multiday Infuser, Baxter) for three days. She obtained adequate analgesia after the surgery without respiratory depression or other major complications. We demonstrated that the continuous epidural infusion of morphine in a patient with myotonic dystrophy is safe and adequate for postoperative pain relief.