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Anesthesia · single question

A patient with Duchenne muscular dystrophy requires an extraction. The safest anesthesia/sedation technique is:

  1. Inferior alveolar nerve block under general anesthesia with volatile agents
  2. Nitrous oxide / oxygen sedation (with local anesthesia)
  3. Mental nerve infiltration only with deep IV sedation by volatile agents
  4. No anesthesia
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Correct answer: B. Nitrous oxide / oxygen sedation (with local anesthesia)

  • A. General anesthesia with volatile agents (and succinylcholine) risks rhabdomyolysis/hyperkalemia and a malignant-hyperthermia-like reaction in DMD; it should be avoided when possible.
  • B. Correct. Nitrous oxide/oxygen sedation combined with local anesthesia avoids the triggering agents and respiratory depressants that are dangerous in DMD, making it the safest option for a minor procedure.
  • C. Volatile-agent deep sedation carries the same triggering risks and respiratory compromise.
  • D. Performing an extraction without anesthesia is inappropriate.

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