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Anaesthesia and neuromuscular disorders: what a neurologist needs to know
- 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.
- Subjects :
- Neuromuscular disease
business.industry
Sedation
Malignant hyperthermia
General Medicine
medicine.disease
Article
03 medical and health sciences
0302 clinical medicine
Muscle disease
030202 anesthesiology
Anesthesia
Medicine
General anaesthesia
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Medical literature
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Pract Neurol
- Accession number :
- edsair.doi.dedup.....968ee8d5d2cd94c7a26c29ca199c88fc