Category Anesthesia

Niemann-Pick Disease

Risk Incidence in live births: 1:100,000-120,000 Affects equally males and females of all ethnic groups NP-D type A frequent in the Ashkenazi-Jewish population No curative therapy, although several symptomatic manifestations are treatable Associated with a decrease in life expectancy, although…

Neuroleptic Malignant Syndrome

Risk Incidence of 0.01–0.02% Mortality rate of 10% 2000 cases of NMS diagnosed annually in USA hospitals Pharmacologic: Typical/“first generation” antipsychotic Rapid dose titration/switching agents/abrupt medication withdrawal/high cumulative dose IM depot/IV administration Multiple concurrent antipsychotics or antipsychotic with lithium/carbamazepine Demographic/miscellaneous:…

Neurofibromatosis

Risk NF-1 birth incidence: 1:3000 NF-2 birth incidence: 1:25,000 Schwannomatosis incidence: 1:40,000 Perioperative Risks Depend on tumor extent and location Worry About Difficult intubation Intraop Htn Intraop tachycardia Overview NF-1, formerly known as von Recklinghausen disease, is a relatively common,…

Nelson Syndrome

Risk Incidence: Reported in 8–44% of pts following bilateral adrenalectomy for Cushing disease More likely in pts with younger age and pregnancy Perioperative Risks Lyte imbalances DI Vision loss Challenges specific to type of surgery Worry About Panhypopituitarism Volume status…

Necrotizing Fasciitis

Risk Incidence in USA: Approximately 9–11.5 cases of invasive streptococcal infections, from which 1–1.8 die each year STSS and NF, each comprising an average of 6–7% of these invasive cases, with an associated mortality of 35–50% for STSS and 29%…

Necrotizing Enterocolitis

Risk Most common life-threatening intestinal surgical emergency in the newborn. Occurs predominantly in premature infants, with 75% in infants weighing <1500 g. Increasing incidence in term and near-term neonates as well. Perioperative Risks CV instability, acidosis, shock, bowel ischemia, bacteremia,…

Narcolepsy

Risk Prevalence approximately 1:2000 Women and men equally affected Prevalence higher in Japan (1:600) Perioperative Risks Potential for masking or mimicking periop complications Potential deleterious interactions between drugs for narcolepsy and drugs administered periop Worry About There is little evidence…

Myxoma

Risk Although primary cardiac tumors are rare (<0.01%), myxoma is the most common type (50%). 75% develop in LA, with most attached to the interatrial septum. Rarely develop in ventricles. More common in females (70%). Perioperative Risks May be friable…

Myoclonic Epilepsy With Ragged Red Fibers

Risk Prevalence: 1:400,000 Maternal inheritance; less commonly a spontaneous mitochondrial gene mutation in those without family Hx Perioperative Risks Lactic acidosis Cardiac/respiratory insufficiency/failure Delayed emergence Worry About Respiratory failure following sedation. Consider aspiration risk. Lactic acidosis. Seizures. Overview Mitochondrial myopathy…