Anaesthesia and neuromuscular disorders

Česká verze

Authors: S. Voháňka ¹; P. Štourač ²; M. Klincová ²
Authors place of work: Neuromuskulární centrum, Neurologická klinika LF MU a FN Brno ¹; Klinika dětské anesteziologie a resuscitace, LF MU a FN Brno ²
Published in the journal: Cesk Slov Neurol N 2018; 81(5): 501-514
Category: Minimonografie
doi: https://doi.org/10.14735/amcsnn2018501

Summary

fragile balance can lead to postponing of necessary interventions, but on the other hand, it can lead to serious risks with improper approaches. Myasthenia is a disease where there is no risk of malignant hyperthermia, and there is an altered sensitivity to peripheral myorelaxants. We prefer to avoid benzodiazepines as a premedication, and after the procedure we always place the patient on a monitored bed with the possibility of artificial ventilation. We do not give suxamethonium to muscular dystrophy and myotonic dystrophy patients and do not use volatile gases due to risk of rhabdomyolysis. There is also no risk of malignant hyperthermia in this group. Malignant hyperthermia is a pharmacogenetic disorder manifested by abnormal hypermetabolic response when exposed to halogenated inhalation anesthetics (halothane, isoflurane, desflurane, sevoflurane) or peripheral muscle relaxants of the depolarizing type (suxamethonium). It can rarely occur even after physical, excessive or heat stress. It is associated with electromechanical coupling and most often occurs with mutations in the ryanodine receptor, but rarely with some other mutations in the genes that are related to calcium metabolism.

Key words:
anaesthesia – myasthenia gravis – muscular dystrophy – myotonic dystrophy – neuromuscular blockade – malignant hyperthermia

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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