Charcot-Marie-Tooth (CMT) disease is the name given to a group of related disorders that affect the peripheral nerves. The peripheral nerves, those outside of the brain and spinal cord, control muscle movement and carry sensory information to the brain. CMT leads to muscle weakness and loss of sensation, especially in the hands and feet.
Anesthetics —agents that induce a local or general loss of sensation, or anesthesia — are potent treatments that affect the nervous system and muscles. People with CMT should take special care when undergoing a procedure that requires local or general anesthesia, telling their doctor about their condition well before any operation.
Anesthesia is a medical treatment that prevents patients from feeling pain during surgical procedures. Anesthetics can be general or local. General anesthetics put patients to sleep during a procedure, while local anesthetics numb a targeted part or parts of the body, allowing patients to remain awake while a procedure is ongoing.
Some forms of CMT can affect breathing and swallowing. This can make anesthesia more dangerous since its use can also suppress breathing. Some anesthetics can have a prolonged effect on CMT patients, meaning the anesthesia and its effects may not wear off as quickly as they should. Even for short procedures, CMT patients may need to stay in hospital for observation for a day or two. Outpatient procedures are not recommended.
Recommendations for CMT patients
During general anesthesia, a muscle relaxant is often combined with the anesthetic. In CMT patients, muscle relaxants usually have a prolonged effect. Certain types of muscle relaxants (called depolarizing muscle relaxants) should be avoided. Inhaled anesthetics are generally safe to use.
Local anesthetics, which work directly on nerve fibers, are reported to have a longer-lasting and more intense effect on CMT patients.
What to do before surgery
It is important for patients to make certain that the anesthesiologist is aware they have CMT. It is especially important that the anesthesiologist is aware of any breathing complications the patient may be or have experienced as a result of this disease.
Other points that a patient should discuss with a surgeon and surgical team include:
- Medications that should not be used in people with CMT
- Any treatments or therapies that the patient may be taking, including over-the-counter and homeopathic remedies
- All possible options, risks, and benefits prior to scheduling surgery
- A pre-surgical assessment with a physical therapist to determine a patient’s likely pre- and post-surgery needs
- The risk of thrombosis (blood clots) and its management
Charcot-Marie-Tooth News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.