Autonomic Neuropathy in Anaesthesia

Abstract

Autonomic neuropathy is a common problem encountered by anaesthetists, both in operating theatres and in the critical care setting. There are a wide variety of causes, many of them associated with significant co-morbidity. It is clear that it is a problem which involves every system on a number of levels, and many of the issues are of particular significance to the anaesthetist. This review will cover briefly the aetiology and diagnosis of autonomic dysfunction, before discussing the clinical manifestations and consequences of the disorder. The major focus will be on cardiovascular autonomic neuropathy (CAN) and its implications for the peri-operative phase. In addition, it will briefly look at the involvement of the enteric nervous system, as well as deal with some of the new concepts emerging in the literature.