PREVALENCE OF UNSUSPECTED MYOPATHY IN INFANTS PRESENTING FOR CLUBFOOTSURGERY

The objective of this study was an evaluation of the prevalence of myo pathies in paediatric patients scheduled for orthopaedic surgery (club foot) performed under regional anaesthesia. Seventeen infants schedule d for lower limb orthopaedic surgery were studied to verify coexisting neuromuscular disorders with electromyography and muscle biopsy durin g surgery. All surgical procedures were performed under caudal block o r spinal anaesthesia, associated with light general anaesthesia. No ma jor cardiorespiratory, neurological or malignant hyperthermic complica tions (muscle rigidity, arrhythmias, hyperpyrexia) were observed. Comb ined neurological, electromyographic and biopsy studies showed a high rate of myopathic changes (70%). Performance of clubfoot surgery under light general anaesthesia with regional techniques was free from any problems. The high rate of myopathic changes (70%) observed in the mus cle biopsies suggests that precautions should be taken with paediatric patients for clubfoot surgery and a regional anaesthesia technique wi th adequate monitoring may be helpful to prevent possible malignant hy perthermia related problems.