Can inhalation agents be used in the presence of a child with myopathy?
OBJECTIVE
Anaesthesia for a child with a muscle disease is always challenging because there is a risk of malignant hyperthermia, rhabdomyolysis or hypermetabolic reaction if a halogenated agent is used. Ongoing progress in genetics helps in clarifying the link between malignant hyperthermia (a calcium channelopathy) and muscle diseases.


RESULTS
We provide a summary of the most recent clinical, pathophysiological and genetic information on those risks when the diagnosis is known or suspected preoperatively. Some simple clues are also given to help make a decision in the presence of an infant or child with hypotonia or motor delay but no diagnosis.


CONCLUSIONS
Only a few muscle diseases are really associated with a risk of malignant hyperthermia. The risk of rhabdomyolysis is more difficult to clarify and a multicentric database would be useful to evaluate the risk/benefit ratio of all anaesthetic drugs in patients with muscle diseases.
Veyckemans
Francis
F
Anesthesiology, Cliniques universitaires St Luc, Catholic University of Louvain Medical School, Brussels, Belgium. francis.veyckemans@uclouvain.be
D000769:Anesthesia, Inhalation / Q000009:adverse effects*; D002675:Child, Preschool; D006012:Glycogen Storage Disease Type V / Q000150:complications / Q000601:surgery; D006801:Humans; D007223:Infant; D008305:Malignant Hyperthermia / Q000209:etiology* / Q000517:prevention & control; D009135:Muscular Diseases / Q000150:complications / Q000601:surgery*; D020391:Muscular Dystrophy, Facioscapulohumeral / Q000150:complications / Q000601:surgery; D020512:Myopathy, Central Core / Q000150:complications / Q000601:surgery; D009223:Myotonic Dystrophy / Q000150:complications / Q000601:surgery; D012206:Rhabdomyolysis / Q000150:complications / Q000601:surgery