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Anesthetic management of patients with Huntington disease

Jonathon E Kivela1, Juraj Sprung, Peter A Southorn

  • 1Departments of Anesthesiology, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Anesthesia and Analgesia
|January 19, 2010
PubMed

Insights

Patients with Huntington disease (HD) tolerate general anesthesia well, contrary to prior concerns. Anesthesiologists should monitor for drug interactions and aspiration risk in HD patients.

Area of Science:

  • Anesthesiology
  • Neurology
  • Genetics

Background:

  • Huntington disease (HD) is a rare autosomal dominant neurodegenerative disorder.
  • Symptoms include chorea, dystonia, cognitive decline, and behavioral issues.
  • Previous case reports raised safety concerns regarding anesthesia in HD patients.

Purpose of the Study:

  • To evaluate the safety and response of Huntington disease patients to general anesthesia.
  • To identify potential anesthetic complications in this patient population.

Main Methods:

  • Computerized search of Mayo Clinic medical records for HD patients undergoing general anesthesia.
  • Review of medical records for anesthetic techniques, medications, and postoperative complications.

Main Results:

  • Eleven genetically confirmed HD patients underwent 17 general anesthetics without adverse effects.
  • Common use of psychiatric medications (antipsychotics, antidepressants, benzodiazepines) did not cause complications.
  • Succinylcholine and nondepolarizing neuromuscular blocking drugs were used safely.

Conclusions:

  • Patients with Huntington disease exhibit normal responses to general anesthesia.
  • Awareness of anesthetic-psychiatric medication interactions is crucial.
  • Minimizing pulmonary aspiration risk is important due to potential bulbar dysfunction in HD.
Abstract

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