Anaesthetic Management of a Patient With LDB3-Associated Myopathy Undergoing Prostate Biopsy Under Total Intravenous Anaesthesia: A Case Report

TL;DR

This case report describes the safe use of total intravenous anesthesia in a patient with LDB3-associated myopathy undergoing a prostate biopsy.

Contribution

The report highlights the use of TIVA as a safe alternative in patients with LDB3-associated myopathy.

Findings

TIVA was safely used in a patient with LDB3-associated myopathy and mild cardiac involvement.

Avoiding volatile agents and neuromuscular blockers was feasible and effective in this case.

Individualized anaesthetic strategies are crucial for patients with neuromuscular diseases.

Abstract

Mutations in the LDB3 gene are implicated in myofibrillar myopathy and cardiomyopathy. Consider cardiac conduction defects and the muscle's sensitivity to some anaesthetics when providing anaesthesia in the perioperative period. We present the anaesthetic management of a 76-year-old man with genetically confirmed LDB3 mutation who presented for prostate biopsy with a background of progressive distal myopathy, mild cardiac involvement, and normal activities of daily living (ADL), undergoing anaesthesia using total intravenous anaesthesia (TIVA) to avoid the use of volatile agents or neuromuscular blockers. In this patient with a history of LDB3-associated myopathy, the use of TIVA provided a safe and effective technique of anaesthesia, and reinforced the need for an individualised anaesthetic strategy in neuromuscular disease (NMD).