Operative management of neuromuscular disorders

Evidence-based neurology checklist on operative management of neuromuscular disorders: Premedication Avoid benzodiazepine premedication if possible Use reduced doses if needed Monitor premedication with pulse oximetry (SpO2) and respiratory rate Preoperative procedure precautions Anaesthetic…

Premedication

  • Avoid benzodiazepine premedication if possible
  • Use reduced doses if needed
  • Monitor premedication with pulse oximetry (SpO2) and respiratory rate

Preoperative procedure precautions

Anaesthetic precautions

Intraoperative anaesthetic monitoring

Intraoperative prevention of heat loss

Intraoperative pain management

Post-operative precautions

Post-operative monitoring: for 24 hours

References

  1. Racca F, Mongini T, Wolfler A, et al. Recommendations for anesthesia and perioperative management of patients with neuromuscular disorders. Minerva Anestesiol 2013; 79:419-433. 
  2. Katz JA, Murphy GS. Anesthetic consideration for neuromuscular diseases. Curr Opin Anaesthesiol 2017; 30:435-440.
  3. Baur CP, Schlecht R, Jurkat-Rott K, Georgieff M, Lehmann-Horn F. Anesthesia in neuromuscular disorders. Part 1: introduction. Anasthesiol Intensivmed Notfallmed Schmerzther 2002; 37:77-83. 
  4. van den Bersselaar LR, Heytens L, Silva HCA, et al. European Neuromuscular Centre consensus statement on anaesthesia in patients with neuromuscular disorders. Eur J Neurol 2022; 29:3486-3507.
  5. Murphy GS. Residual neuromuscular blockade: incidence, assessment, and relevance in the postoperative period. Minerva Anestesiol 2006; 72:97-109.

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