General Anesthetic Management for Laparoscopic Appendectomy in a Patient With Myotonia Congenita: A Case Report.

Abstract

A 57-year-old man with myotonia congenita underwent elective laparoscopic appendectomy after perforated appendicitis treated with two drainages. Quadratus lumborum blocks were preoperatively placed bilaterally under ultrasound guidance. Anesthetic gases and succinylcholine were avoided, and total intravenous anesthesia was used for maintenance. Neuromuscular blockade was minimized and reversed with sugammadex. The operative course was uneventful. In the postanesthesia care unit, the patient reported a pain level of zero throughout his stay, required no opioids, and was discharged the same day with unremarkable surgical follow-up.