Vecuronium titration for muscle relaxation in myotonic dystrophy

A 14-year-old boy with pronounced myotonic dystrophy and cardiac malformation had a normal ED₉₅ (53 μg·kg^?1) of vecuronium, whereas the recovery index (25-75% twitch recovery) was three times as long as in the absence of neuromuscular disease. We conclude that in young patients with dystrophic muscle disease individual titration of the muscle relaxant with the aid of a nerve stimulator does not preclude a considerable delay in the recovery of neuromuscular transmission.