Management of anaesthesia in children with neuromuscular diseases
Authors:
P. Balážová 1; K. Viestová 1; I. Martinka 2; P. Zahradnikova 3; M. Kolníková 1; B. Nedomová 4
Authors‘ workplace:
Klinika detskej neurológie LF UK a NÚDCH, Bratislava, Slovensko
1; Neurologická klinika SZU a UNB, Bratislava, Slovensko
2; Klinika detskej chirurgie LF UK a NÚDCH, Bratislava, Slovensko
3; Detská klinika anestéziológie a intenzívnej medicíny LF UK, LF SZU a NÚDCH, Bratislava, Slovensko
4
Published in:
Cesk Slov Neurol N 2024; 87(3): 165-173
Category:
Review Article
doi:
https://doi.org/10.48095/cccsnn2024165
Overview
Neuromuscular diseases (NMDs) in childhood represent a markedly heterogenous group of acquired and congenital diseases, many of which are rare. Due to extramuscular complications of NMDs, pediatric patients often require anesthesia for medical procedures. The specific management of NMDs during perioperative periods requires the collaboration of an experienced anesthesiologist and several other experts involved in patient care. It is essential also for neurologists to be familiar with the challenges that anesthesia brings to NM patients. Improper management of anesthesia in an inadequately prepared and equipped workplace can lead to patient endangerment, possibly irreversible deterioration of the patient’s condition. The article provides general recommendations for perioperative management of patients with NMDs, specific complications associated with anesthesia, and recommendations for selected NMDs. A comprehensive overview of anesthetic management in NMDs may help to improve the neurologist´s orientation in the care for this rare group of patients.
Keywords:
neuromuscular diseases – Anesthesia – complications – malignant hyperthermia
Sources
1. van den Bersselaar LR, Heytens L, Silva HCA et al. European Neuromuscular Centre consensus statement on anaesthesia in patients with neuromuscular disorders. Eur J Neurol 2022; 29(12): 3486– 3507. doi: 10.1111/ ene.15526.
2. Nedomová B. Anestézia v detskej ortopédii. In: Mixa V et al. Dětská anestezie. 1. vyd. Praha: Mladá fronta 2019: 347– 370.
3. Marsh S, Ross N, Pittard A. Neuromuscular disorders and anaesthesia. Part 1: generic anaesthetic management. Continuing Education in Anaesthesia Critical Care & Pain 2011; 11(4): 115– 118. doi: 10.1093/ bjaceaccp/ mkr020.
4. van den Bersselaar LR, Snoeck MMJ, Gubbels M et al. Anaesthesia and neuromuscular disorders: what a neurologist needs to know. Pract Neurol 2020 [ahead of print]. doi: 10.1136/ practneurol-2020-002633.
5. Rosenberg H, Davis M, James D et al. Malignant hyperthermia. Orphanet J Rare Dis 2007; 2: 21. doi: 10.1186/ 1750-1172-2-21.
6. Schneiderbanger D, Johannsen S, Roewer N et al. Management of malignant hyperthermia: diagnosis and treatment. Ther Clin Risk Manag 2014; 10: 355– 362. doi: 10.2147/ TCRM.S47632.
7. Kim KSM, Kriss RS, Tautz TJ. Malignant hyperthermia: a clinical review. Adv Anesth 2019; 37: 35– 51. doi: 10.1016/ j. aan.2019.08.003.
8. Vojtíšková J. Maligní hypertermie. Pediatr praxi 2017; 18: 368– 372.
9. Hopkins PM, Girard T, Dalay S et al. Malignant hyperthermia 2020: Guideline from the Association of Anaesthetists. Anaesthesia 2021; 76(5): 655– 664. doi: 10.1111/ anae.15317.
10. Gray RM. Anesthesia-induced rhabdomyolysis or malignant hyperthermia: is defining the crisis important? Paediatr Anaesth 2017; 27(5): 490– 493. doi: 10.1111/ pan.13130.
11. Poole TC, Lim TYJ, Buck J et al. Perioperative cardiac arrest in a patient with previously undiagnosed Becker’s muscular dystrophy after isoflurane anaesthesia for elective surgery. Br J Anaesth 2010; 104(4): 487– 489.
12. Brandsema JF, Darras BT. Dystrophinopathies. Semin Neurol 2015; 35(4): 369– 384. doi: 10.1055/ s-0035-1558982.
13. Muenster T, Mueller C, Forst J et al. Anaesthetic management in patients with Duchenne muscular dystrophy undergoing orthopaedic surgery: a review of 232 cases. Eur J Anaesthesiol 2012; 29(10): 489– 494. doi: 10.1097/ EJA.0b013e3283566789.
14. Birnkrant DJ, Bushby K, Bann CM et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. Lancet Neurol 2018; 17(4): 347– 361. doi: 10.1016/ S1474-4422(18)30025-5.
15. Birnkrant DJ, Panitch HB, Benditt JO et al. American College of Chest Physicians consensus statement on the respiratory and related management of patients with Duchenne muscular dystrophy undergoing anesthesia or sedation. Chest 2007; 132(6): 1977– 1986. doi: 10.1378/ chest.07-0458.
16. Marsh S, Pittard A. Neuromuscular disorders and anaesthesia. Part 2: specific neuromuscular disorders. Continuing Education in Anaesthesia Critical Care & Pain 2011; 11(4): 119– 123. doi: 10.1093/ bjaceaccp/ mkr
019.
17. Soltanzadeh P. Myotonic dystrophies: a genetic overview. Genes (Basel) 2022; 13(2): 367. doi: 10.3390/ genes 13020367.
18. van den Bersselaar LR, Heytens L, Silva HCA et al. The European Neuromuscular Centre consensus statement on anaesthesia in patients with neuromuscular disorders. Eur J Neurol 2022; 29(12): 3486– 3507. doi: 10.1111/ ene.15526.
19. Johnson NE, Aldana EZ, Angeard N et al. Consensus-based care recommendations for congenital and childhood-onset myotonic dystrophy type 1. Neurol Clin Pract 2019; 9(5): 443– 454. doi: 10.1212/ CPJ. 0000000000000646.
20. Cassandrini D, Trovato R, Rubegni A et al. Congenital myopathies: clinical phenotypes and new diagnostic tools. Ital J Pediatr 2017; 43(1): 101. doi: 10.1186/ s13052-017-0419-z.
21. Claeys KG. Congenital myopathies: an update. Dev Med Child Neurol 2020; 62(3): 297– 302. doi: 10.1111/ dmcn.14365.
22. Bissonnette B, Luginbuehl I, Marciniak B et al. Myotubular myopathy. In: Bissonnette B. Syndromes: rapid recognition and perioperative implications. New York, USA: The McGraw-Hill Companies 2006.
23. Ahmed ST, Craven L, Russell OM et al. Diagnosis and Treatment of Mitochondrial Myopathies. Neurotherapeutics 2018; 15(4): 943– 953. doi: 10.1007/ s13311-018-00674-4.
24. Olimpio C, Tiet MY, Horvath R. Primary mitochondrial myopathies in childhood. Neuromuscul Disord 2021; 31: 978– 987.
25. Niezgoda J, Morgan PG. Anesthetic considerations in patients with mitochondrial defects. Paediatr Anaesth 2013; 23(9): 785– 793. doi: 10.1111/ pan.12158.
26. van den Bersselaar LR, Riazi S, Snoeck M et al. 259th ENMC international workshop: Anaesthesia and neuromuscular disorders 11 December, 2020 and 28– 29 May, 2021. Neuromuscul Disord 2022; 32(1): 86– 97. doi: 10.1016/ j. nmd.2021.11.005.
27. Singh A, Anjankar AP. Propofol-related infusion syndrome: a clinical review. Cureus 2022; 14(10): e30383. doi: 10.7759/ cureus.30383.
28. Peragallo JH. Pediatric myasthenia gravis. Semin Pediatr Neurol 2017; 24(2): 116– 121. doi: 10.1016/ j. spen.2017.04.003.
29. Vanhaesebrouck AE, Beeson D. The congenital myasthenic syndromes: expanding genetic and phenotypic spectrums and refining treatment strategies. Curr Opin Neurol 2019; 32(5): 696– 703. doi: 10.1097/ WCO.0000000000000736.
30. Roberts J, Reddy U. Neuromuscular disorders: relevance to anaesthesia and intensive care. Anaesth Int Care Med 2017; 18(6): 292– 295. doi: 10.1016/ j. mpaic. 2017.03.009.
31. Masters OW, Bagshaw ON. Anaesthetic considerations in paediatric myasthenia gravis. Autoimmune Dis 2011; 2011: 250561. doi: 10.4061/ 2011/ 250561.
32. Neuman A, Granlund B. Anesthesia for patients with myasthenia gravis. Treasure Island, FL, USA: StatPearls Publishing 2023.
33. Korinthenberg R, Trollmann R, Felderhoff-Müser U et al. Diagnosis and treatment of Guillain-Barré Syndrome in childhood and adolescence: an evidence- and consensus-based guideline. Eur J Paediatr Neurol 2020; 25: 5– 16. doi: 10.1016/ j. ejpn.2020.01.003.
34. Malek E, Salameh J. Guillain-Barre syndrome. Semin Neurol 2019; 39(5): 589– 595. doi: 10.1055/ s-0039-1693005.
35. Tomar GS, Sethi A, Kriplani T et al. Anaesthesia in a diagnosed ventricular septal defect with Guillain-Barré paediatric patient for videoassisted thoracic surgery. Indian J Anaesth 2010; 54(4): 345– 346. doi: 10.4103/ 0019-5049.68389.
36. Jani-Acsadi A, Ounpuu S, Pierz K et al. Pediatric Charcot-Marie-Tooth disease. Pediatr Clin North Am 2015; 62(3): 767– 786. doi: 10.1016/ j. pcl.2015.03.012.
37. Prior TW, Leach ME, Finanger E. Spinal Muscular Atrophy. In: Adam MP, Everman DB, Mirzaa GM et al. (eds). GeneReviews®. Seattle, WA, USA: University of Washington, Seattle 1993.
38. Liu XF, Wang DX, Ma D. Using general anesthesia plus muscle relaxant in a patient with spinal muscular atrophy type IV: a case report. Case Rep Anesthesiol 2011; 2011: e743587. doi: 10.1155/ 2011/ 743587.
Labels
Paediatric neurology Neurosurgery NeurologyArticle was published in
Czech and Slovak Neurology and Neurosurgery
2024 Issue 3
Most read in this issue
- Relationship between the occurrence of benign fasciculations, patient‘s psychological profile, biochemical parameters, and mutations in the SMN1 gene
- Management of anaesthesia in children with neuromuscular diseases
- Virtual reality in rehabilitation of patients after stroke
- Painful legs and moving toes syndrome – two case reports