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Prolonged Neuromuscular Paralysis with Vecuronium in a Patient with Polymyositis

Departments of Anesthesia and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Abstract

Certain patients with dermatomyositis show a profound peripheral weakness. In some, this weakness is improved with the administration of anticholinesterase drugs. In 1958, Churchill-Davidson and Richardson investigated ten patients with dermatomyositis (1). They found evidence of a myasthenic response (using decamethonium) in two: in one of these patients a bronchogenic neoplasm was present. These authors caution, therefore, that muscle relaxants be used carefully when anesthetizing patients with dermatomyositis. The present report describes a case of prolonged neuromuscular blockade with the shortacting, nondepolarizing relaxant vecuronium in a patient with polymyositis who subsequently displayed no abnormality of neuromuscular transmission on electromyographic testing.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999