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Can inhalation agents be used in the presence of a child with myopathy?

Veyckemans, Francis

Current Opinion in Anesthesiology: June 2010 - Volume 23 - Issue 3 - p 348–355
doi: 10.1097/ACO.0b013e3283393977
Pediatric anaesthesia: Edited by Walid Habre

Purpose of review 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.

Recent findings 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.

Summary 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.

Anesthesiology, Cliniques universitaires St Luc, Catholic University of Louvain Medical School, Brussels, Belgium

Correspondence to Francis Veyckemans, Anesthesiology, Cliniques universitaires St Luc, Catholic University of Louvain Medical School, Avenue Hippocrate 10-1821, B 1200 Brussels, Belgium Tel: +32 2 7641821; e-mail: francis.veyckemans@uclouvain.be

© 2010 Lippincott Williams & Wilkins, Inc.