Copper and Anesthesia: Clinical Relevance and Management of Copper Related Disorders

Abstract

Recent research has implicated abnormal copper homeostasis in the underlying pathophysiology of several clinically important disorders, some of which may be encountered by the anesthetist in daily clinical practice. The purpose of this narrative review is to summarize the physiology and pharmacology of copper, the clinical implications of abnormal copper metabolism, and the subsequent influence of altered copper homeostasis on anesthetic management.

Anaesthetic Management of a Patient With Wilson’s Disease Posted for Emergency Lscs: A Case Report

“…9 Copper accumulation may lead to erythrocyte hemolysis resulting in Coombs negative haemolytic anaemia (10-15%). 10 Pre-existing neuro psychological problems may get aggravated by the hypnotic and sedative drugs. Excessive copper may interfere with neuromuscular transmission.…”

“…Excessive copper may interfere with neuromuscular transmission. 10 Decreased pseudocholinesterase levels slow the metabolism of succinyl choline. This may increase the risks of airway management, RSI (Rapid Sequence Induction) for General anaesthesia in Obstetric population.…”

“…An INR < 1.4 or platelets > 100,000 mm −3 is acceptable for a CNB. 10,11 Pre-existing neurological deficiency must be documented before attempting an Epidural or a subarachnoid block. The disease status at the time of presentation for surgery should determine the mode of Anaesthesia, intraoperative management and post-operative care.…”

Assessment of Lead, Cadmium, Copper and Zinc Content in Women’s Blood During II Trimester of Gestation

“…Copper as a trace element plays an important in the maturation of hematopoietic cells, in normal pregnancy and embryogenesis, fetal and post-natal growth. Lower plasma copper levels have been found in some conditions diagnosed during the first trimester including a spontaneous, threatened and missed abortion and a blighted ovum [9].…”

“…Copper deficiency can result in anemia, neutropenia, bone marrow dysplasia, chronic intrauterine hypoxia, fetal hypotrophy, coagulation abnormalities [9,10]. Serum and placental copper levels and placental lipid peroxides, a marker of oxidative stress, were increased in women with a severe preeclampsia [11].…”