Malignant Hyperthermia during Desflurane-Succinylcholine Anesthesia for Orthopedic Surgery

Garrido, Sergio; Fraga, Marcial; Martín, Maria J.

doi:10.1097/00000542-199904000-00037

Cited by 8 publications

(2 citation statements)

References 5 publications

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“…Halothane and isoflurane were the only volatile agent triggers in this review. However all potent inhalational agents have been implicated [15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

Suspected Malignant Hyperthermia Reactions in New Zealand

Pollock

Langton

Couchman

et al. 2002

Anaesth Intensive Care

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Early clinical signs, triggering agents, time to onset of reaction, mortality and methods of treatment were identified in 123 suspected malignant hyperthermia reactions. In vitro contracture test results were compared with clinical signs and the Malignant Hyperthermia Clinical Grading Scale. Increased end-tidal carbon dioxide is the earliest sign when not preceded by masseter spasm. Earlier diagnosis reduces the incidence of rigidity and severe metabolic acidosis. The combination of suxamethonium and a potent volatile anaesthetic agent triggers an earlier reaction compared with a volatile agent alone. There has been zero mortality since 1981, essentially due to a combination of advanced monitoring capability, increased anaesthetist awareness of malignant hyperthermia, and dantrolene availability. DNA analysis has identified nine New Zealand families with ryanodine receptor gene mutations. A positive DNA test indicates malignant hyperthermia susceptibility with "causative" mutations but discordance requires that negative DNA tests are confirmed with in vitro contracture test. This test also demonstrated the shortcomings of the Malignant Hyperthermia Clinical Grading Scale.

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“…Halothane and isoflurane were the only volatile agent triggers in this review. However all potent inhalational agents have been implicated [15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

Suspected Malignant Hyperthermia Reactions in New Zealand

Pollock

Langton

Couchman

et al. 2002

Anaesth Intensive Care

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“…However, MH using the volatile anesthetic desflurane has been infrequently reported in humans. [ 30 31 32 33 ] These agents along with phenothiazines and monoamine oxidase inhibitors should be strictly avoided and if possible removed from the operating room altogether. [ 1 34 ] A total intravenous anesthetic regime using propofol, opioids, and non-depolarizing muscle relaxants may be most appropriate.…”

Section: Discussionmentioning

confidence: 99%

Successful management of hypothermic cardiopulmonary bypass in a malignant hyperthermia susceptible patient

et al. 2020

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Malignant hyperthermia (MH) is a potentially lethal reaction in those that are genetically predisposed, frequently triggered by inhaled anesthetics. MH is often difficult to diagnose because it is accompanied by signs and symptoms that are shared with other disorders. The diagnosis is further obscured in cardiac surgical patients, as the signs of MH can be masked by the cardiopulmonary bypass circuit (CPB) and the use of induced hypothermia. In this case-report, we describe the successful anesthetic management of a 65-year-old MH-susceptible female, confirmed via caffeine halothane contracture test, with aortic regurgitation and ascending aortic dilatation who underwent a Bentall procedure. We have also identified certain key measures for the safe anesthetic management of these patients.

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