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Anaesthesia and neuromuscular disorders: what a neurologist needs to know

Authors :
Nicol C. Voermans
Luuk R van den Bersselaar
Erik-Jan Kamsteeg
Sheila Riazi
M.M.J. Snoeck
Heinz Jungbluth
Madelief Gubbels
Source :
Pract Neurol
Publication Year :
2020

Abstract

Neurologists are often asked for specific advice regarding patients with neuromuscular disease who require general anaesthesia. However, guidelines on specific neuromuscular disorders do not usually include specific guidelines or pragmatic advice regarding (regional and/or general) anaesthesia or procedural sedation. Furthermore, the medical literature on this subject is mostly limited to publications in anaesthesiology journals. We therefore summarise general recommendations and specific advice for anaesthesia in different neuromuscular disorders to provide a comprehensive and accessible overview of the knowledge on this topic essential for clinical neurologists. A preoperative multidisciplinary approach involving anaesthesiologists, cardiologists, chest physicians, surgeons and neurologists is crucial. Depolarising muscle relaxants (succinylcholine) should be avoided at all times. The dose of non-depolarising muscle relaxants must be reduced and their effect monitored. Patients with specific mutations in RYR1 (ryanodine receptor 1) and less frequently in CACNA1S (calcium channel, voltage-dependent, L type, alpha 1S subunit) and STAC3 (SH3 and cysteine rich domain 3) are at risk of developing a life-threatening malignant hyperthermia reaction.

Details

Language :
English
Database :
OpenAIRE
Journal :
Pract Neurol
Accession number :
edsair.doi.dedup.....968ee8d5d2cd94c7a26c29ca199c88fc