Anesthesia for Children with Neuromuscular Diseases

Neuromuscular disorders (NMDs) are a heterogenous group of conditions characterized by myopathy due to the involvement of peripheral nerve, neuromuscular junction, or muscle. Children with diagnosed or undiagnosed NMDs pose unique challenges to an anesthesiologist owing to their multisystem involvement and increased susceptibility to severe, often fatal anesthesia-related complications. Anesthesiologists cater to these children as a part of diagnostic workup (e.g., muscle biopsy or magnetic resonance imaging), disease-related surgical procedures (e.g., scoliosis surgeries), incidental surgeries, or in intensive care scenarios. A thorough understanding of the pathophysiology of the disease process and anesthetic implications are critical in the perioperative management of these patients. Similarly, preoperative discussion with a neurologist and meticulous planning are essential to manage a “floppy” child with undiagnosed myopathy successfully.