Knowledge Gaps in the Perioperative Management of Adults With Narcolepsy: A Call for Further Research

Shelley Hershner, Yves Dauvilliers, Frances Chung, Mandeep Singh, Jean Wong, Bhargavi Gali, Rahul Kakkar, Emmanuel Mignot, Michael J. Thorpy, Dennis Auckley

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

There is increasing awareness that sleep disorders may be associated with increased perioperative risk. The Society of Anesthesia and Sleep Medicine created the Narcolepsy Perioperative Task Force: (1) to investigate the current state of knowledge of the perioperative risk for patients with narcolepsy, (2) to determine the viability of developing perioperative guidelines for the management of patients with narcolepsy, and (3) to delineate future research goals and clinically relevant outcomes. The Narcolepsy Perioperative Task Force established that there is evidence for increased perioperative risk in patients with narcolepsy; however, this evidence is sparse and based on case reviews, case series, and retrospective reviews. Mechanistically, there are a number of potential mechanisms by which patients with narcolepsy could be at increased risk for perioperative complications. These include aggravation of the disease itself, dysautonomia, narcolepsy-related medications, anesthesia interactions, and withdrawal of narcolepsy-related medications. At this time, there is inadequate research to develop an expert consensus or guidelines for the perioperative management of patients with narcolepsy. The paucity of available literature highlights the critical need to determine if patients with narcolepsy are at an increased perioperative risk and to establish appropriate research protocols and clearly delineated patient-centered outcomes. There is a real need for collaborative research among sleep medicine specialists, surgeons, anesthesiologists, and perioperative providers. This future research will become the foundation for the development of guidelines, or at a minimum, a better understanding how to optimize the perioperative care of patients with narcolepsy.

Original languageEnglish (US)
Pages (from-to)204-211
Number of pages8
JournalAnesthesia and analgesia
Volume129
Issue number1
DOIs
StatePublished - Jul 1 2019

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Narcolepsy
Research
Advisory Committees
Guidelines
Sleep
Anesthesia
Primary Dysautonomias
Medicine
Perioperative Care
Consensus

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Hershner, S., Dauvilliers, Y., Chung, F., Singh, M., Wong, J., Gali, B., ... Auckley, D. (2019). Knowledge Gaps in the Perioperative Management of Adults With Narcolepsy: A Call for Further Research. Anesthesia and analgesia, 129(1), 204-211. https://doi.org/10.1213/ANE.0000000000004088

Knowledge Gaps in the Perioperative Management of Adults With Narcolepsy : A Call for Further Research. / Hershner, Shelley; Dauvilliers, Yves; Chung, Frances; Singh, Mandeep; Wong, Jean; Gali, Bhargavi; Kakkar, Rahul; Mignot, Emmanuel; Thorpy, Michael J.; Auckley, Dennis.

In: Anesthesia and analgesia, Vol. 129, No. 1, 01.07.2019, p. 204-211.

Research output: Contribution to journalArticle

Hershner, S, Dauvilliers, Y, Chung, F, Singh, M, Wong, J, Gali, B, Kakkar, R, Mignot, E, Thorpy, MJ & Auckley, D 2019, 'Knowledge Gaps in the Perioperative Management of Adults With Narcolepsy: A Call for Further Research', Anesthesia and analgesia, vol. 129, no. 1, pp. 204-211. https://doi.org/10.1213/ANE.0000000000004088
Hershner, Shelley ; Dauvilliers, Yves ; Chung, Frances ; Singh, Mandeep ; Wong, Jean ; Gali, Bhargavi ; Kakkar, Rahul ; Mignot, Emmanuel ; Thorpy, Michael J. ; Auckley, Dennis. / Knowledge Gaps in the Perioperative Management of Adults With Narcolepsy : A Call for Further Research. In: Anesthesia and analgesia. 2019 ; Vol. 129, No. 1. pp. 204-211.
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