Perioperative Management in Neuromuscular Diseases: A Narrative Review

Area of Science:

• Anesthesiology
• Neurology
• Critical Care Medicine

Background:

• Patients with neuromuscular diseases (NMDs) exhibit heightened vulnerability during the perioperative period.
• They are at increased risk for pulmonary and cardiac complications, adverse medication effects, and thermoregulation issues.

Purpose of the Study:

• To raise awareness of the unique surgical challenges in patients with NMDs.
• To guide clinicians on perioperative evaluations and interventions for favorable surgical outcomes.

Main Methods:

• This review synthesizes current knowledge on perioperative management for NMD patients.
• It emphasizes risk identification, pre-operative assessment, intraoperative strategies, and post-operative care.

Main Results:

• Pre-operative evaluation is crucial for identifying risks and initiating interventions like cardiology consultation or pulmonary function tests.
• Intraoperative management requires careful attention to patient positioning, airway control, anesthesia, and ventilation.
• Postoperative care involves managing electrolyte imbalances, secretions, pain, and medication to prevent complications such as reintubation.

Conclusions:

• Proactive and tailored perioperative management is essential for mitigating risks in patients with NMDs.
• Implementing specific interventions at each stage can significantly improve surgical outcomes and patient safety.