Recommendations for anesthesia and perioperative management of patients with neuromuscular disorders

F. Racca, T. Mongini, A. Wolfler, A. Vianello, R. Cutrera, L. Del Sorbo, E. C. Capello, C. Gregoretti, R. Massa, D. De Luca, G. Conti, V. Tegazzin, A. Toscano, V. M. Ranieri

Research output: Contribution to journalArticlepeer-review

Abstract

Patients with neuromuscular disorders are at high risk of intraoperative and postoperative complications. General anesthesia in these patients may exacerbate respiratory and cardiovascular failure due to a marked sensitivity to several anesthetic drugs. Moreover, succinylcholine and halogenated agents can trigger life-threatening reactions, such as malignant hyperthermia, rhabdomyolysis and severe hyperkalemia. Therefore, regional anesthesia should be used whenever possible. If general anesthesia is unavoidable, special precautions must be taken. In particular, for patients at increased risk of respiratory complications (i.e., postoperative atelectasis, acute respiratory failure, nosocomial infections), noninvasive ventilation associated with aggressive airway clearance techniques can successfully treat upper airway obstruction, hypoventilation and airway secretion retention, avoiding prolonged intubation and tracheotomy. Anesthesia and perioperative management of patients with neuromuscular disorders are described in this article. To grade the strength of recommendations and the quality of evidence we adopted the GRADE approach. In case of low-quality evidence, these recommendations represent the collective opinion of the expert panel.

Original languageEnglish
Pages (from-to)419-433
Number of pages15
JournalMinerva Anestesiologica
Volume79
Issue number4
Publication statusPublished - Apr 2013

Keywords

  • Anesthesia
  • Insufflation
  • Neuromuscular diseases
  • Noninvasive ventilation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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