Evaluation of suspected malignant hyperthermia events during anesthesia

BMC Anesthesiology

Norbert Roewer¹  Daniel Schneiderbanger¹  Stephan Johannsen¹  Frank Schuster¹ 

[1]Department of Anesthesia and Critical Care, University of Wuerzburg, Oberduerrbacher Str. 6, D-97080 Wuerzburg, Germany

关键词: Volatile anesthetics;    Succinylcholine;    In vitro contracture test;    Malignant hyperthermia;   

Others  :  816773
DOI  :  10.1186/1471-2253-13-24

 received in 2012-11-20, accepted in 2013-09-19,  发布年份 2013

【 摘 要 】

Background

Malignant hyperthermia (MH), a metabolic myopathy triggered by volatile anesthetics and depolarizing muscle relaxants, is a potentially lethal complication of general anesthesia in susceptible patients. The implementation of modern inhalation anesthetics that research indicates as less potent trigger substances and the recommended limitations of succinylcholine use, suggests there may be considerable decline of fulminant MH cases. In the presented study, the authors analyzed suspected MH episodes during general anesthesia of patients that were referred to the Wuerzburg MH unit between 2007 and 2011, assuming that MH is still a relevant anesthetic problem in our days.

Methods

With approval of the local ethics committee data of patients that underwent muscle biopsy and in vitro contracture test (IVCT) between 2007 and 2011 were analyzed. Only patients with a history of suspected MH crisis were included in the study. The incidents were evaluated retrospectively using anesthetic documentation and medical records.

Results

Between 2007 and 2011 a total of 124 patients were tested. 19 of them were referred because of suspected MH events; 7 patients were diagnosed MH-susceptible, 4 MH-equivocal and 8 MH-non-susceptible by IVCT. In a majority of cases masseter spasm after succinylcholine had been the primary symptom. Cardiac arrhythmias and hypercapnia frequently occurred early in the course of events. Interestingly, dantrolene treatment was initiated in a few cases only.

Conclusions

MH is still an important anesthetic complication. Every anesthetist must be aware of this life-threatening syndrome at any time. The rapid onset of adequate therapy is crucial to avoid major harm and possibly lethal outcome. Dantrolene must be readily available wherever MH triggering agents are used for anesthesia.

【 授权许可】

   
2013 Schuster et al.; licensee BioMed Central Ltd.

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