Myotonic dystrophy
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Associated structural valvular/valve disease. Consider physiological implications if present

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May 18, 2011
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Bulbar palsy common. If present, consider post op ventilation if major surgery.

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May 18, 2011
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Cardiomyopathies are associated and may be present. #ref

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Aug 30, 2011
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Diabetes type 2 NIDDM often associated. Consider investigating for related renal/cardiac disease if undergoing major surgery.

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May 18, 2011
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Consider invasive blood pressure monitoring if patient has a significant cardiomyopathy and is undergoing major surgery. #ref

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Jan 16, 2012
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Keep them warm to reduce shivering which may initiate myotonia

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Apr 05, 2012
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Neostigmine may provoke muscle contraction. Use short acting non-depolarising muscle relaxants instead.

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May 18, 2011
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Non-depolarising muscle relaxants NDMR safe to use, but often not effective.

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May 18, 2011
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Nerve stimulator may stimulate prolonged contraction.

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May 18, 2011
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Regional anaesthesia where possible

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May 18, 2011
At increased risk of respiratory depression from opiates/opiods.
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Risk of opiod induced respiratory depression. If general anaesthesic, consider monitoring in HDU/oximetry in bed near nurses in ward

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May 18, 2011
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The goal of anesthetic management is to prevent the known triggers of myotonic crisis (hypothermia, shivering, & hyperkalemia); & to avoid depolarizing muscle relaxants & anticholinesterase agents

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Jul 14, 2011
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