Anaesthetic Guidelines

General Anaesthetic can be dangerous for people with DM. Often Medical Professionals are not 100% aware of the severity of the danger, so we have produced a reference guide.

This is helpful to print off and take to appointments with you.

 Quick View Anaesthetic Guidelines - CureDM.

Sourced from MDUK Complex Care plans and Consensus based care guidelines

* Risk is not defined by previous GA’s or severity of disorder.

* I am at risk of anaesthetic complications because of my Neuromuscular Condition – Myotonic Dystrophy. (Please don’t confuse with Muscular Dystrophy as DM has specific risks)

* I am at increased risk of Cardiac Dysrhythmia and Ventricular Impairment and should be on a continuous ECG after any General Anaesthetic, for a minimum of 24-48 hours – to catch any symptoms early.

* I may be extremely sensitive to, or develop a reaction to certain anaesthetic agents, including malignant hyperthermia. Suxamethonium/succinylcholine MUST BE AVOIDED in GA.

* During any GA, the room should be warmed, or warming blankets used. And fluids should be warmed to room temperature to avoid myotonia during the operation.

*I should be allowed to wake naturally, and not have breathing equipment removed until I am fully awake.

*I am at risk of delayed recovery after GA or sedation and will need a higher level of post-operative care.

*It is imperative there is an HDU/ICU bed available for planned procedures.

*I will need to be on a continuous SATS monitor to monitor my O2 levels, for a minimum of 24-48 hours as my condition has an increased risk of delayed issues – often presenting at the 24-hour point.

* I should be on a continuous ECG for 24 hours to enable any changes to be found early. These can be delayed in Myotonic Dystrophy.

* I may have a higher risk of pneumonia because of aspiration and weak respiratory muscles, specifically after a GA.

* I may be more sensitive to the effects of opioid analgesics and sedatives as these may worsen my breathing function and consciousness. AVOID Morphine and associated opioids after any GA.

* Please do not give me oxygen without monitoring my Carbon Dioxide Levels as I am at a high risk of CO2 retention, even though my O2 levels are stable. If a BIPAP is used in my normal care, Oxygen should only be given through my Bipap machine.

* Patients with DM have reduced Na/K pump and are at risk of hyperkalaemia and are sensitive to excess potassium. Only give extra potassium if clinically required. It can also exacerbate myotonia and pain.

THIS IS A GUIDE. PLEASE READ ANAESTHETIC GUIDELINES FOR FULL INFORMATION.

 

 

You can download a printable version by clicking here.