Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026850 (muscular dystrophy)
 5,870 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anesthesia for patients with muscular dystrophy is a great challenge to the anesthesiologists. A 56-year-old female with muscular dystrophy was diagnosed as having colon cancer. Since surgical intervention was indicated, epidural anesthesia with double catheters was performed. The entire anesthetic course was uneventful. Based on the experience obtained, it is concluded that epidural anesthesia offers a good alternative to general anesthesia for major abdominal surgery complicated by muscular dystrophy.
 ...
PMID:Epidural anesthesia for major abdominal surgery complicated by muscular dystrophy--a case report. 272 87

The purpose of this retrospective study was to estimate the frequency and severity of anaesthetic complications in patients with Duchenne's muscular dystrophy (DMD). Forty-four boys with DMD were exposed to anaesthesia and surgery 84 times during a period of 22 years (1965-86). The procedures took place at 15 different hospitals. Retrospective examination of the case records showed: 19 cases with local analgesia without any complications, and 18 of 65 general anaesthetics with minor or more serious complications. In ten cases an increase in body temperature above 37.5 degrees C was seen, five had abdominal pain and dark-coloured urine after surgery, and three had a critical perioperative course with a resemblance to malignant hyperthermia. The complications were almost exclusively related to the use of succinylcholine. The use of succinylcholine was dispersed through all ages. Three out of the eight patients with severe complications occurred 1.5, 2.5 and 4 years before the neuromuscular disease was diagnosed. Thus an unusual course of anaesthesia in male children calls for further investigation. Although it has been stated before that succinylcholine is contraindicated in patients with Duchenne's muscular dystrophy, the drug continues to be used.
 ...
PMID:Complications during anaesthesia in patients with Duchenne's muscular dystrophy (a retrospective study) 231 Nov 64

Clinical uses of calcium channel blockers are expanding. In addition to the established uses in patients with arrhythmias, angina pectoris or hypertension, newer and to some extent investigational uses indicate widespread application. For instance, their use has been reported in hypertrophic cardiomyopathy and cold cardioplegia, as well as in pulmonary hypertension, antiplatelet therapy, asthma, achalasia and oesophageal spasm, increased intraocular pressure and in cerebral vasospasm. Their use in obstetrical practice has been proposed. Thus, the presentation of a patient who is treated with calcium channel blockers and who requires anaesthesia will become more common. Calcium channel blockers may, under certain circumstances, potentiate haemodynamic and MAC depressive effects of inhalation agents. There is also evidence that the effects of neuromuscular blocking agents may be potentiated. The anaesthetist should be aware that the potential for interactions exists with digoxin, propranolol, quinidine, theophylline or dantrolene. Of interest and some significance are the anaesthetic implications of pathophysiological alterations that can be induced by calcium channel blockers, by affecting lower oesophageal tone, intracranial hypertension, bronchomotor tone (asthma), muscular dystrophy, neuromuscular function, hypoxic pulmonary vasoconstriction, malignant hyperthermia, inhibition of platelet aggregation and hyperkalemia. Despite these significant potential anaesthetic implications and because, at this time, in some instances withdrawal has clearly demonstrated increase in the signs of myocardial ischaemia, it would not seem necessary to recommend preoperative discontinuation of calcium channel blocker medication in patients presenting for anaesthesia. It is, however, appropriate that there is a high index of awareness of potential problems, unless there is some modification in inhalation anaesthetic concentrations and neuromuscular blocker dosage. Monitoring of cardiovascular and neuromuscular functions is essential. Calcium channel blockers would appear to be currently the drugs of choice for angina pectoris, arrhythmias or hypertension in patients with associated chronic obstructive pulmonary disease.
 ...
PMID:Anaesthetic implications of calcium channel blockers. 286 80

We describe the anaesthetic management of a patient with a rare form of muscular dystrophy (Facioscapulohumeral or Landouzy-Dejerine type). Anaesthesia and controlled ventilation using alfentanil-nitrous oxide and atracurium was satisfactory. In this patient, sensitivity to atracurium was found to be similar to that of the normal population, but more rapid recovery was observed.
 ...
PMID:Anaesthetic management of a patient with facioscapulohumeral muscular dystrophy. 293 Jun 76

Four boys belonging to a group of children affected by a rare form of muscular dystrophy with eye and brain involvement, termed the "muscle, eye and brain disease" (MEB), were anaesthetized for various eye examinations and surgery. On some occasions succinylcholine was used during anaesthesia and the initially elevated serum creatine kinase (CK) values increased from a range of 122 to 1200 units.L-1 to a range of 4350 to 9690 units.L-1 22 hours after anaesthesia. CK values after anaesthesia without succinylcholine remained at the initially elevated levels. Rectal temperatures of the children were normal. These findings suggest that succinylcholine should be avoided in patients with MEB disease.
 ...
PMID:Serum creatine kinase levels after succinylcholine in children with "muscle, eye and brain disease". 334 59

Cardiac arrest occurred in a 5 1/2-year-old child with suspected Duchenne's muscular dystrophy ten minutes following induction of anaesthesia with halothane, nitrous oxide and oxygen. No muscle relaxants were administered. The cardiac arrest was associated with hyperkalaemia, acidosis, myoglobinuria, elevated serum creatine phosphokinase and a 1.6 degrees C rise in temperature. The child made a complete recovery after receiving 90 minutes of cardiopulmonary resuscitation.
 ...
PMID:Cardiac arrest following inhalation induction of anaesthesia in a child with Duchenne's muscular dystrophy. 377 2

The presentation and features of Duchenne's progressive muscular dystrophy (Duchenne's PMD) are described and the increased risks associated with anaesthesia are considered. Hazards associated with induction of anaesthesia and immediate postoperative recovery have been stressed in recent case reports, and these are summarized. Features of a hyperpyrexia-like response including cardiac arrest, increased serum creatine phosphokinase concentration, myoglobinuria and metabolic acidosis following suxamethonium or halothane, or both, have been described in patients with Duchenne's PMD. Subsequent in vitro muscle tests have suggested that it is possible that a malignant hyperpyrexia response to general anaesthesia may occur. Six children known to have Duchenne's PMD who developed delayed respiratory insufficiency following anaesthesia and required controlled pulmonary ventilation are reported. In five of the children, cardiac arrest occurred despite apparently adequate respiratory support. Suxamethonium was common to the anaesthetic received by all six patients. In one of these patients subsequent anaesthetics, without suxamethonium, were uneventful and delayed muscle weakness did not occur.
 ...
PMID:Anaesthesia and progressive muscular dystrophy. 405 3

Since the first report in 1846 on the use of anesthesia for a surgical procedure, deaths have occurred with practically every agent and technique used. Those mishaps of which we are aware are probably just a small segment of those that have actually occurred, since presently there is no widely used method for identifying anesthesia-associated deaths. Several sources of information are available, including the United States National Center for Health Statistics and articles in the medical literature. Neither of these encompasses more than a fraction of the total experience; in addition, the population upon which most reports are based and the number of anesthesias involved are usually not available as a denominator in determining the incidence of mishaps and the magnitude of the problem. Extrapolating from data from community anesthesia study committees and from population and operative figures, we can estimate that there are over 5,000 deaths associated with anesthesia in this country each year. This is 3 times as many as are caused by muscular dystrophy and multiple sclerosis, 15 times as many as with sickle cell anemia, 20 times as many as with myasthenia gravis and 40 times as many with poliomyelitis. We thus must recognize that anesthesia is an iatrogenic disease that deserves serious attention as a public health problem.
 ...
PMID:Anesthesia mortality. 461 16

Units for the investigation of susceptibility to malignant hyperthermia (MH) were set up in Denmark in 1977 and in Sweden in 1981. Two hundred and ten patients from 76 families have been investigated. The diagnosis of MH susceptibility (MHS) was made by in vitro exposure of muscle from vastus medialis to halothane and to caffeine. MHS criteria for the patients in this paper were established from examination of 31 control biopsies, obtained from the same muscle and with the same anaesthesia as the MH patients. The criteria have since been changed to those presented elsewhere in this issue. In our laboratories the halothane test (exposure to 0.5-2% halothane) was the more sensitive: 88% of MHS patients reacted to it. The caffeine test was positive in 68% of MHS patients, 0.5-2.0 mmol litre-1 solutions being the most discriminating. Forty-two percent of MHS patients reacted to only one test. Fulminant MH was the most common reason for investigation; all these families contained MHS members. Masseter spasm occurred as sole sign in 21 families, of which 11 were MHS. Only 10% of MHS patients had other signs or symptoms of neuromuscular disease such as muscle cramps or muscular dystrophy. Three families had experienced sudden infant death syndrome (SIDS), and two teenage brothers in a MHS family died suddenly, but death was unrelated to anaesthesia.
 ...
PMID:Investigation of malignant hyperthermia in Denmark and Sweden. 648 40

A case is described of a child with ocular muscular dystrophy, who demonstrated the extreme sensitivity to non-depolarising muscle relaxants, with lack of reversal by anticholinesterases, characteristic of this condition.
Anaesthesia 1984 Mar
PMID:Ocular muscular dystrophy. A cause of curare sensitivity. 670 94


<< Previous 1 2 3 4 5 6 7 8 Next >>