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Patients were categorized prebiopsy into six groups: M (myopathy and muscular dystrophy), <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> (mitochondrial or metabolic myopathy), N (neurodegenerative, peripheral neuropathy or spinal muscular atrophy disorder), D (dermatomyositis), C (cardiomyopathy), or S (seizure disorder). Data were collected for demographics, anesthetic management, pre\u2010 and postoperative anesthesia\u2010induced muscle injury, postbiopsy histopathologic diagnosis, and concordance comparisons between pre\u2010 and postbiopsy diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 513 males (58.5%) and 364 females (41.5%) (1.4:1) with 137 individuals (15.6%) operated on under 1\u00a0year of age and two\u2010thirds by 6\u00a0years of age. <jats:styled-content style=\"fixed-case\">NMD<\/jats:styled-content> diagnosis was reached in 409 (46.6%) while 468 (53.4%) had no specific pathology. No patients exhibited signs of anesthesia\u2010induced muscle injury (malignant hyperthermia, rhabdomyolysis, cardiac arrest, or postoperative deterioration of weakness). <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> was the largest group pre biopsy (367, 41.8%). Anesthetic agents were: nitrous oxide in 657 (74.9%); volatile agents in 139 (15.8%); intravenous agents in 836 (95.3%) (primarily propofol, midazolam, and fentanyl); nondepolarizing muscle relaxants in 404 (46.1%); and regional anesthesia in 112 (12.8%) [most commonly spinal anesthesia in 80 (71.4%)]. Comparing preoperative diagnostic category with postoperative diagnosis, there was a concordance of 78% (319\/409) between the two for cases with a definitive diagnosis and 89.7% (787\/877) for all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this retrospective study, no patient exhibited signs or symptoms of hyperkalemia or <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content> probably because the incidence is very low and becomes even less likely due to the selection of the various anesthetic agents and strategies administered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12909","type":"journal-article","created":{"date-parts":[[2016,4,25]],"date-time":"2016-04-25T14:46:03Z","timestamp":1461595563000},"page":"710-721","source":"Crossref","is-referenced-by-count":29,"title":["Anesthetic management of 877 pediatric patients undergoing muscle biopsy for neuromuscular disorders: a 20\u2010year review"],"prefix":"10.1111","volume":"26","author":[{"given":"Frederic","family":"Shapiro","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Boston Children's Hospital Boston MA USA"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umeshkumar","family":"Athiraman","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston MA USA"},{"name":"Department of Anesthesiology Perioperative and Pain Medicine Boston Children's Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Clendenin","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston MA USA"},{"name":"Department of Anesthesiology Perioperative and Pain Medicine Boston Children's Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Hoagland","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston MA USA"},{"name":"Department of Anesthesiology Perioperative and Pain Medicine Boston Children's Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navil F.","family":"Sethna","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston MA USA"},{"name":"Department of Anesthesiology Perioperative and Pain Medicine Boston Children's Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2006.02105.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000324929.33780.2f"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2011.03.006"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880110507"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1978.00500280007002"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2013.11.003"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31829c2dc8"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/01480540903207076"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03027134"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198803000-00028"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-010-0096-4"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2011.605389"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181d31ebd"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.2106\/00004623-199303000-00018","article-title":"The diagnosis and orthopaedic treatment of inherited muscular diseases of childhood","volume":"75","author":"Shapiro F","year":"1993","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_10_16_1","first-page":"75","volume-title":"Neuromuscular Disorders of Infancy, Childhood and Adolescence: A Clinician's Approach","author":"Anthony DC","year":"2002"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e328351b521"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181ee2cb7"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198809000-00018"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e31818874d3"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03022831"},{"key":"e_1_2_10_22_1","unstructured":"ASA Physical Classification System 2013. 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