Anesthetic management and implications of pediatric patients with a diagnosis of anti-N-methyl-D-aspartate receptor encephalitis: two case reports.

This article discusses the anesthetic management and implications of 2 pediatric patients with a diagnosis of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis. Anti-NMDA receptor encephalitis has been described as an immune-meditated syndrome that triggers the production of antibodies to the NMDA receptor: a site of action for many commonly used anesthetic agents. Symptoms of this disease can be autonomic, neurologic, and psychological in nature. This disease process can pose a challenge to the anesthesia provider during all stages of the anesthetic. Thus, the anesthesia provider must incorporate an understanding of the administered anesthetic agent's potential pharmacologic effect on the affected NMDA receptor when formulating the patient's anesthetic plan.