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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Total thyroidectomy in patient with McArdle's syndrome: Anaesthetic manageme...
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Vol. 66. Issue 3.
Pages 163-166 (March 2019)
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Vol. 66. Issue 3.
Pages 163-166 (March 2019)
Case report
Total thyroidectomy in patient with McArdle's syndrome: Anaesthetic management
Tiroidectomía total en paciente con síndrome de McArdle: manejo anestésico
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A.V. Quintero Salvago
Corresponding author
anavsalvago@gmail.com

Corresponding author.
, J.D. Leal del Ojo del Ojo, L. Barrios Rodríguez, J.J. Fedriani de Matos, I. Morgado Muñoz
Servicio de Anestesiología y Reanimación, Hospital de Jerez de la Frontera, Jerez de la Frontera (Cádiz), Spain
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Table 1. Recommended anaesthetic management in patients with McArdle's scheduled for surgery.
Abstract

McArdle disease or type V glycogenosis is a rare metabolic myopathy consisting of muscle loss and weakness. These patients have risks associated with anaesthesia. They can present with hypoglycaemia, rhabdomyolysis, acute renal failure, and electrolyte changes. It has also been associated with a higher incidence of malignant hyperthermia during the anaesthetic procedure. Intermittent compression due to the measurement of non-invasive pressure, postures on the operating table that may cause muscle contractures, or tremor caused by hypothermia or anaesthesia itself, may trigger rhabdomyolysis in these patients.

In this article we present our experience in submitting a patient with McArdle's syndrome to general anaesthesia for total thyroidectomy due to multinodular euthyroid goitre.

Keywords:
McArdle's syndrome
Glycogenosis
General anaesthesia
Myopathy
Myoglobinuria
Hypoglycaemia
Malignant hyperthermia
Resumen

La enfermedad de McArdle o glucogenosis de tipo V es una miopatía metabólica rara que consiste en pérdida muscular y debilidad. Los pacientes con esta enfermedad presentan riesgos asociados a la anestesia. Pueden presentar hipoglucemia, rabdomiólisis, fallo renal agudo, alteraciones iónicas y también se ha relacionado con una mayor incidencia de hipertermia maligna durante el procedimiento anestésico. La compresión intermitente debido a la medición de la presión no invasiva, las posturas en la mesa de quirófano que puedan provocar contracturas musculares o el temblor ocasionado por la hipotermia o por la misma anestesia pueden desencadenar rabdomiólisis en estos pacientes. En este artículo exponemos nuestra experiencia con una paciente con síndrome de McArdle bajo anestesia general para tiroidectomía total por bocio multinodular eutiroideo.

Palabras clave:
Síndrome de McArdle
Glucogenosis
Anestesia general
Miopatía
Mioglobinuria
Hipoglucemia
Hipertermia maligna

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