Lung Ultrasound -- New OA-POCUS of the Month episode now available!
Our April 2025 episode continues from last month
Patient Advocacy in the Hospital and Society
The May 2025 PAINTS vodcast with Dr. Ashlee Murray is now available!
The Brain in Pregnancy: Eclampsia
The April 2025 episode of OA-SOAP Fellows Webinar, with Dr. Anna G. Euser is now available!
Have you visited our External Resources page lately? New content has been added! Use the filters to find just what you're looking for.
New! Create a free account on OpenAnesthesia.org!
We want to know more about you to create the content you seek!
Check out the latest OpenAnesthesia Summaries!
More than 400 mini-reviews on high-yield topics in anesthesiology, critical care, and perioperative medicine.
Question of the Day
A 45-year-old man with myotonic dystrophy, type 1 and acute appendicitis presents for a laparoscopic appendectomy. Which of the following statements about the perioperative management of patients with myotonic dystrophy is MOST correct?
Explanation
Myotonic dystrophy, type 1 (Steinert's disease) is characterized by muscle weakness and wasting (most prominent in the cranial and distal limb musculature), periodic myotonia, progressive myopathy, insulin resistance, defects in cardiac conduction, neuropsychiatric impairment, cataracts, testicular atrophy, and frontal balding in males. Mitral valve prolapse may be found in 20% of patients. The majority of perioperative complications are pulmonary: smooth muscle atrophy, which leads to poor gastric motility, when coupled with a diminished cough reflex, promotes aspiration. Succinylcholine will produce contractions lasting for several minutes, thus making intubation and ventilation a challenge. Succinylcholine should be avoided. Patients are not resistant to nondepolarizing muscle relaxants and short-acting nondepolarizing muscle relaxants (or avoidance of relaxation) are therefore advised. If a nondepolarizing muscle relaxant is used, reversal of neuromuscular blockade is not contraindicated. Patients with myotonic dystrophy can be very sensitive to anesthetic agents, with hypersomnolence and CO2 retention sometimes being observed.
References:
Mathieu J, Allard P, Gobeil G, Girard M, De Braekeleer M, Bégin P. Anesthetic and surgical complications in 219 cases of myotonic dystrophy. Neurology. 1997;49(6):1646-1650. doi:10.1212/wnl.49.6.1646 Catena V, Del Monte DD, Rubini A, et al. Anesthesia and myotonic dystrophy (Steinert's syndrome). The role of total intravenous anesthesia with propofol, cisatracurium and remifentanyl. Case report. Minerva Anestesiol. 2007;73(9):475-479. Myotonic DystrophyOA Series: May 2025
10:48
OA-POCUS Case of the Month
Lung UltrasoundAshley Vincent, MD, Duke University Health System, Durham, NC, Diana Hsu, MD, Duke University Health System, Durham, NC, Sophia Dunworth, MD, Duke University Health System, Durham, NC, Yuriy Bronshteyn, MD, FASE, Duke University Health System, Durham, NC
Copy link
18:14
PAINTS
Patient Advocacy in the Hospital and SocietyAshlee Murray, MD, MPH, Children's Hospital of Philadelphia, Philadelphia, PA
Copy link
42:33
OA-SOAP Fellows Webinar Series
The Brain in Pregnancy: EclampsiaAnna G. Euser, MD, PhD, University of Colorado, Aurora, CO
Copy link