PMID: 9538480Apr 16, 1998Paper

Malignant hyperthermia

Postgraduate Medical Journal
R Ben AbrahamA Perel

Abstract

Malignant hyperthermia is a rare autosomal dominant trait that predisposes affected individuals to great danger when exposed to certain anaesthetic triggering agents (such as potent volatile anaesthetics and succinylcholine). A sudden hypermetabolic reaction in skeletal muscle leading to hyperthermia and massive rhabdomyolysis can occur. The ultimate treatment is dantrolene sodium a nonspecific muscle relaxant. Certain precautions should be taken before anaesthesia of patients known to be susceptible to malignant hyperthermia. These include the prohibition of the use of triggering agents, monitoring of central body temperature and expired CO2, and immediate availability of dantrolene. In addition, careful cleansing of the anaesthesia machine of vapours of halogenated agents is recommended. If these measures are taken, the chances of an MH episode are greatly reduced. When malignant hyperthermia-does occur in the operating room, prompt recognition and treatment usually prevent a potentially fatal outcome. The most reliable test to establish susceptibility to malignant hyperthermia is currently the in vitro caffeine-halothane contracture test. It is hoped that in the future a genetic test will be available.

References

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Citations

Jun 20, 2006·European Journal of Anaesthesiology·D ScalaG Savoia
Dec 1, 2002·Journal of Clinical Neuromuscular Disease·Josef Finsterer
Nov 12, 2009·Orthopedics·Rachel C StratmanKevin W Hatton
Jun 6, 2003·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Eran HadadRon Ben-Abraham
Oct 12, 2010·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Jeffrey K Aronson, Robin E Ferner
Oct 3, 2006·Current Opinion in Anaesthesiology·P J Adnet, G A Gronert
Jun 23, 2012·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Ashton E BeggsJan M Powers
Jun 11, 2011·Journal of the American College of Surgeons·John E ZiewaczAtul A Gawande

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