title: Undiagnosed myopathy before surgery and safe anaesthesia table.
abstract: Patients with muscle pathology are a challenge for anaesthesiologists because of possible life-threatening general anaesthesia complications. A review of the current medical literature on the issue clearly indicates that increasing awareness by anaesthesiologists in recent years has led to a reduction in the occurrence of adverse events in patients with diagnostically well-defined muscle disease. On the other hand, the current emerging aspect is that the great majority of complications concern subjects with clinically non-overt (silent to mildly symptomatic) and thus undiagnosed myopathy. With a view to improving prevention of possible critical anaesthesia complications in such patients, we present a "Safe Anaesthesia Table", listing both the anaesthetic drugs to be avoided and those considered harmless for myopathic patients, irrespective of age and type of pathology. In addition, a brief outline about the clinical aspects suggestive of a possible muscle pathology is also provided. Using "safe drugs" during routine surgical procedures in subjects with suspected undiagnosed myopathy will enable the anaesthesiologist to avoid delaying surgery, while protecting them from anaesthesia complications. By following this approach the presumed myopathy can be properly investigated after surgery.
authors.affiliation: Università di Padova, Padova, Italy;
authors.forename: Carlo P
authors.initials: CP
authors.lastname: Trevisan
authors.affiliation: O. C. Bentivoglio, Bologna, Italy;
authors.forename: Alma
authors.initials: A
authors.lastname: Accorsi
authors.affiliation: Istituto Neurologico "C. Besta", Milano, Italy;
authors.forename: Lucia O
authors.initials: LO
authors.lastname: Morandi
authors.affiliation: Università di Torino, Torino, Italy;
authors.forename: Tiziana
authors.initials: T
authors.lastname: Mongini
authors.affiliation: O. Cardarelli, Napoli, Italy;
authors.forename: Gennaro
authors.initials: G
authors.lastname: Savoia
authors.affiliation: Università Federico II, Napoli, Italy;
authors.forename: Elvira
authors.initials: E
authors.lastname: Gravino
authors.affiliation: Università di Padova, Padova, Italy;
authors.forename: Corrado
authors.initials: C
authors.lastname: Angelini
authors.affiliation: O. S. Antonio, Padova, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tegazzin
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods; D000777:Anesthetics / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification; D058070:Asymptomatic Diseases; D002648:Child; D000075202:Contraindications; D003951:Diagnostic Errors / Q000517:prevention & control*; D016903:Drug Monitoring / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions / Q000145:classification / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D009135:Muscular Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D064406:Patient Harm / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods
chemical_list: D000777:Anesthetics
keywords: anaesthesia complications; hyperCKemia; safe anaesthesia; undiagnosed myopathy