TY - JOUR
T1 - Knowledge Gaps in the Perioperative Management of Adults with Narcolepsy
T2 - A Call for Further Research
AU - Hershner, Shelley
AU - Dauvilliers, Yves
AU - Chung, Frances
AU - Singh, Mandeep
AU - Wong, Jean
AU - Gali, Bhargavi
AU - Kakkar, Rahul
AU - Mignot, Emmanuel
AU - Thorpy, Michael
AU - Auckley, Dennis
N1 - Publisher Copyright:
© 2018 International Anesthesia Research Society.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85068427216&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068427216&partnerID=8YFLogxK
U2 - 10.1213/ANE.0000000000004088
DO - 10.1213/ANE.0000000000004088
M3 - Article
C2 - 30882519
AN - SCOPUS:85068427216
SN - 0003-2999
VL - 129
SP - 204
EP - 211
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 1
ER -