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.
KeywordsAnesthesia Neuromuscular diseases Noninvasive ventilation Mechanical insufflation-exsufflation Malignant hyperthermia
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