Anaesthesia in children with neuromuscular disease

Anaesthesia in children with a neuromuscular disease is challenging the anaesthesiologist. In this group occur frequently perioperative complications from muscle weakness, respiratory depression and cardiac involvement. Lack of experience is the reason for uncertainty. Knowledge of the pathophysiology and relevant pharmacology of the disease, preoperative development of an adequate treatment plan with consultation of other disciplines, and close monitoring of the patient are extremely important. The various diseases can be divided according to the location of the disorder: pre-junctional, junctional, post-junctional. Many of them are described in this article. Only few patients are susceptible for malignant hyperthermia. Rhabdomyolyis can be induced by inhalational anaesthesia and succinylcholine in many of these diseases, whereas in most a prolonged effect of muscle relaxants exist and succinylcholine may induce myotonic reactions. The complications and anaesthetic effects in many neuromuscular diseases are described. Anestezjologia i Ratownictwo 2013; 7: 39-52.