Abstract
Patients affected by neuromuscular disorders are at high risk of intraoperative and postoperative complications. General anesthesia in these patients may exacerbate respiratory and cardiovascular failure due to a marked sensitivity to several anesthetic drugs. Moreover, succinylcholine and halogenated agents can trigger life-threatening reactions. Thus, in these children, a proactive and multidisciplinary approach should be instituted before, during, and after any surgical procedure requiring general anesthesia or sedation. This chapter will review the pathophysiology of life-threatening complications of anesthesia in NMDs and the assessment and management of these patients before, during, and after anesthesia.
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References
Racca F, Mongini T, Wolfler A, et al. Recommendations for Anesthesia and Perioperative management of patients with neuromuscular disorders. Minerva Anestesiol. 2013;79:419–33.
Hull J, Aniapravan R, Chan E, Chatwin M, Forton J, Gallagher J, Gibson N, Gordon J, Hughes I, McCulloch R, Russell RR, Simonds A. British Thoracic Society guideline for respiratory management of children with neuromuscular weakness. Thorax. 2012;67:i1ei40.
Bushby K, Finkel R, Birnkrant DJ, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177–89.
Marik PE, Varon J. Requirement of perioperative stress doses of corticosteroids: a systematic review of the literature. Arch Surg. 2008;143(12):1222–6.
Yong SL, Marik P, Esposito M, Coulthard P. Supplemental perioperative steroids for surgical patients with adrenal insufficiency. Cochrane Database Syst Rev. 2009;(4):CD005367.
Petrini F, Accorsi A, Adrario E, et al. Recommendations for airway control and difficult airway management. Minerva Anestesiol. 2005;71(11):617–57.
Frova G, Guarino A, Petrini F, et al. Recommendations for airway control and difficult airway management in paediatric patients. Minerva Anestesiol. 2006;72(9):723–48.
Wappler F. Malignant hyperthermia. Eur J Anaesthesiol. 2001;18:632.
Brady JE, Sun LS, Rosenberg H, Li G. Prevalence of malignant hyperthermia due to anesthesia in New York State, 2001-2005. Anesth Analg. 2009;109:1162.
Glahn KPE, et al. Recognizing and managing a malignant hyperthermia crisis: guidelines from the European Malignant Hyperthermia Group. Br J Anaesth. 2010;105(4):417–20.
Veyckemans F. Can inhalation agents be used in the presence of a child with myopathy? Curr Opin Anaesthesiol. 2010;23(3):348–55.
de Boer HD, van Esmond J, Booij LH, Driessen JJ. Reversal of rocuronium-induced profound neuromuscular block by sugammadex in Duchenne muscular dystrophy. Paediatr Anaesth. 2009;19(12):1226–8.
Unterbuchner C, Fink H, Blobner M. The use of sugammadex in a patient with myasthenia gravis. Anaesthesia. 2010;65(3):302–5.
Bach JR, Goncalves MR, Hamdani I, Winck JC. Extubation of patients with neuromuscular weakness: a new management paradigm. Chest. 2010;137(5):1033–9.
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Racca, F., Gily, B. (2019). Neuromuscular Diseases. In: Chiumello, D. (eds) Practical Trends in Anesthesia and Intensive Care 2018. Springer, Cham. https://doi.org/10.1007/978-3-319-94189-9_7
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DOI: https://doi.org/10.1007/978-3-319-94189-9_7
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