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Neuromuscular and mitochondrial disorders: what is relevant to the anaesthesiologist?

Driessen, Jacques J

Current Opinion in Anesthesiology: June 2008 - Volume 21 - Issue 3 - p 350–355
doi: 10.1097/ACO.0b013e3282f82bcc
Pediatric anesthesia: Edited by Bernard J. Dalens

Purpose of review 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.

Recent findings 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.

Summary 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.

Department of Anesthesiology, University Medical Center Radboud, Nijmegen, The Netherlands

Correspondence to J.J. Driessen, Geert Grooteplein 10, 6500 HB Nijmegen, The Netherlands Tel: +31 24 3614553; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.