Metabolic Disorders and Anesthesia

Curr Anesthesiol Rep. 2019 Sep;9(3):340-359. doi: 10.1007/s40140-019-00345-w. Epub 2019 Jul 12.

Abstract

Purpose of review: Metabolic disorders encompass a group of inherited inborn errors of metabolism that are uncommonly encountered but can pose challenges when encountered during the perioperative period. Hence, it is paramount that anesthesiologists are experienced and familiar with management of these conditions.

Recent findings: Hundreds of inborn errors of metabolism have already been identified, yet new metabolic disorders continue to be discovered with advancements in genomic science.

Summary: In our general review, we define the more common metabolic disorders encountered in perioperative medicine and discuss the perioperative anesthetic considerations and challenges associated with each disorder. The following disorders are covered in our review: disorders of carbohydrate metabolism, disorders of amino acid metabolism, disorders of branched-chain amino acid metabolism, organic acidemias, mitochondrial disorders, lysosomal storage disorders, metal metabolism disorders, and urea cycle disorders.

Keywords: Amino acid metabolism; Anesthesia; Branched-chain amino acid metabolism; Carbohydrate metabolism; Lysosomal storage disorders; Metabolic disorders; Metal metabolism disorders; Mitochondrial disorders; Organic acidemias; Urea cycle disorders.