Inclusion body myositis and anesthesia: A case series

Andrew R. Mortenson, Juraj Sprung, Alexandre N. Cavalcante, James Watson, Toby N. Weingarten

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Study Objective Inclusion body myositis is a painless inflammatory myopathy affecting older adults. It manifests as progressive muscle atrophy and weakness, typically affecting proximal lower extremity muscles initially but insidiously progressing to affect other muscles, including bulbar (oropharyngeal) muscles and the diaphragm, and leading to dysphagia and respiratory insufficiency. This study reviews the perioperative outcomes of patients with inclusion body myositis who received general anesthesia. Design Observational retrospective study. Setting Academic tertiary referral center. Patients Patients with inclusion body myositis from October 1, 2009, to September 30, 2015, undergoing procedures requiring general anesthesia. Interventions Perioperative health records were reviewed. Measurements Perioperative outcomes and complications were assessed, with emphasis on respiratory complications and unexpected reactions to succinylcholine and nondepolarizing neuromuscular blocking drugs. Main Results Sixteen patients with inclusion body myositis underwent 18 procedures requiring general anesthesia. Succinylcholine was used during induction in 6 cases (33.3%) and nondepolarizing neuromuscular blocking drugs in 11 cases (61.1%). For 13 patients (72.2%), the trachea was extubated at the end of surgery, and none had postoperative respiratory complications. The 5 patients who continued to have tracheal intubation were expected to require continuous mechanical ventilation postoperatively. Three patients died within 30 days of surgery. One patient underwent a tracheostomy for planned long-term mechanical ventilation but life support was withdrawn after 22 days, and 2 severely deconditioned patients died at 11 and 15 days following general anesthesia for endoscopic procedures. Conclusions Our patients with inclusion body myositis had uneventful perioperative outcomes following general anesthesia with depolarizing and nondepolarizing muscle relaxants. The small patient cohort in our series precludes a definitive conclusion regarding the safety of anesthetic agents in this patient population.

Original languageEnglish (US)
Pages (from-to)282-287
Number of pages6
JournalJournal of Clinical Anesthesia
Volume31
DOIs
StatePublished - Jun 1 2016

Fingerprint

Inclusion Body Myositis
Anesthesia
General Anesthesia
Succinylcholine
Artificial Respiration
Muscles
Neuromuscular Depolarizing Agents
Myositis
Muscular Atrophy
Tracheostomy
Muscle Weakness
Deglutition Disorders
Diaphragm
Trachea
Ambulatory Surgical Procedures
Intubation
Tertiary Care Centers
Respiratory Insufficiency
Pharmaceutical Preparations
Observational Studies

Keywords

  • Adverse events
  • General anesthesia
  • Inclusion body myositis
  • Nondepolarizing neuromuscular blocking drug
  • Respiratory failure
  • Succinylcholine

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Mortenson, A. R., Sprung, J., Cavalcante, A. N., Watson, J., & Weingarten, T. N. (2016). Inclusion body myositis and anesthesia: A case series. Journal of Clinical Anesthesia, 31, 282-287. https://doi.org/10.1016/j.jclinane.2016.02.018

Inclusion body myositis and anesthesia : A case series. / Mortenson, Andrew R.; Sprung, Juraj; Cavalcante, Alexandre N.; Watson, James; Weingarten, Toby N.

In: Journal of Clinical Anesthesia, Vol. 31, 01.06.2016, p. 282-287.

Research output: Contribution to journalArticle

Mortenson, Andrew R. ; Sprung, Juraj ; Cavalcante, Alexandre N. ; Watson, James ; Weingarten, Toby N. / Inclusion body myositis and anesthesia : A case series. In: Journal of Clinical Anesthesia. 2016 ; Vol. 31. pp. 282-287.
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