Neuromuscular and mitochondrial disorders: what is relevant to the anaesthesiologist?
OBJECTIVE
The review provides an up-to-date information to the anaesthesiologist about the more frequent and important neuromuscular disorders for which new basic insights or clinical implications have been reported.


RESULTS
The findings include the mechanisms of the hyperkalemia after succinylcholine in patients with upregulation of acetylcholine receptors. New insights into the mechanism of malignant hyperthermia-like reactions such as rhabdomyolysis during anaesthesia in patients with Duchenne muscular dystrophy have been published. The importance of mitochondrial defects and the effect of agents used in anaesthesia on mitochondrial function are also highlighted.


CONCLUSIONS
The increased understanding of the genetics and pathophysiology of common muscle disorders may lead to a decrease in life-threatening complications related to surgery and anaesthesia. However, there is still a lack of prospective clinical studies to determine which is the safest anaesthetic technique for these patients.
Driessen
Jacques J
JJ
Department of Anesthesiology, University Medical Center Radboud, Nijmegen, The Netherlands. JJ.Driessen@anes.umcn.nl
D000776:Anesthesiology; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced; D008305:Malignant Hyperthermia / Q000209:etiology; D028361:Mitochondrial Diseases / Q000235:genetics / Q000503:physiopathology; D009222:Myotonia / Q000235:genetics / Q000503:physiopathology; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects; D009468:Neuromuscular Diseases / Q000235:genetics / Q000503:physiopathology; D011978:Receptors, Nicotinic / Q000187:drug effects; D012206:Rhabdomyolysis / Q000139:chemically induced; D013390:Succinylcholine / Q000009:adverse effects
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D009467:Neuromuscular Depolarizing Agents; D011978:Receptors, Nicotinic; D013390:Succinylcholine