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Neuromuscular disorders and anesthesia.

R D Stevens1

  • 1Department of Anesthesia and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland 21287, USA. rstevens@jhmi.edu

Current Opinion in Anaesthesiology
|October 5, 2006
PubMed
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Neuromuscular disorders impair cardiopulmonary function and airway protection, complicating anesthesia. This review covers motor neuron diseases, neuropathies, myasthenic syndromes, and myopathies, focusing on perioperative management.

Area of Science:

  • Anesthesiology
  • Neurology
  • Critical Care Medicine

Background:

  • Neuromuscular disorders present unique challenges in anesthesia due to compromised cardiopulmonary reserves and airway defenses.
  • Limited evidence exists for optimal perioperative management of many rare neuromuscular conditions.

Purpose of the Study:

  • To review recent data on the pathogenesis and medical management of specific neuromuscular disorders.
  • To outline studies relevant to anesthesia and the perioperative care of patients with these conditions.

Main Methods:

  • Literature review of recent data on neuromuscular disorders.
  • Synthesis of information on pathogenesis, medical management, and anesthetic considerations.

Main Results:

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  • Neuromuscular disorders are linked to reduced cardiopulmonary function and impaired airway protection.
  • Anesthetic management requires careful consideration of atypical drug responses and disease-specific pathophysiology.

Conclusions:

  • Anesthesiologists must be aware of the specific risks associated with motor neuron diseases, peripheral neuropathies, myasthenic syndromes, and myopathies.
  • Evidence-based guidelines for the perioperative care of patients with neuromuscular disorders are needed to improve clinical practice.