Duchenne muscular dystrophy: an old anesthesia problem revisited.
Patients with Duchenne and Becker muscular dystrophy suffer from a progressive deterioration in muscle secondary to a defect in the dystrophin gene. As such, they are susceptible to perioperative respiratory, cardiac and other complications, such as rhabdomyolysis. Inhalational anesthetic agents have been implicated as a cause of acute rhabdomyolysis that can resemble malignant hyperthermia (MH). This article reviews perioperative 'MH-like' reactions reported in muscular dystrophy patients and groups them into three categories according to clinical presentation. The etiology and underlying pathophysiological process responsible for these reactions is discussed and recommendations are proposed for the safe anesthetic management of these patients.
Hayes
Jason
J
The Hospital for Sick Children, Toronto, ON, Canada. jason.hayes@sickkids.ca
Veyckemans
Francis
F
Bissonnette
Bruno
B
D000293:Adolescent; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006323:Heart Arrest / Q000150:complications / Q000209:etiology; D006801:Humans; D006947:Hyperkalemia / Q000150:complications; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D008305:Malignant Hyperthermia / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D010372:Pediatrics; D019990:Perioperative Care; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*
D018685:Anesthetics, Inhalation