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Malignant hyperthermia: current perspectives

J Felice-Johnson, T Sudds, G Bennett

    American Journal of Hospital Pharmacy
    |May 1, 1981
    PubMed
    Summary
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    Malignant hyperthermia (MH) is a dangerous pharmacogenetic reaction to anesthesia, triggered by specific genes and environmental factors. Early dantrolene sodium administration and preventative measures are crucial for managing MH crises and preventing recurrence.

    Area of Science:

    • Anesthesiology
    • Pharmacogenetics
    • Medical Genetics

    Background:

    • Malignant hyperthermia (MH) is a significant cause of anesthesia-related mortality.
    • This pharmacogenetic syndrome results from a combination of genetic predisposition and environmental triggers.
    • Susceptibility is linked to metabolic defects affecting calcium dynamics within muscle cells.

    Purpose of the Study:

    • To review the incidence, etiology, clinical manifestations, and management of malignant hyperthermia.
    • To highlight the importance of early diagnosis and intervention in MH cases.
    • To discuss screening methods and preventative strategies for individuals at risk.

    Main Methods:

    • Review of existing literature on malignant hyperthermia.
    • Analysis of the pathophysiology involving calcium release and uptake.

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  • Evaluation of clinical management strategies and diagnostic techniques.

    • Main Results:

    • MH triggers include specific anesthetic agents and physical/emotional stress.
    • Key symptoms include muscle rigidity, tachycardia, tachypnea, and hyperthermia, potentially leading to death.
    • Effective management involves cooling, hyperventilation, sodium bicarbonate, fluid balance, and dantrolene sodium.

    Conclusions:

    • Early dantrolene sodium administration rapidly resolves MH symptoms and complications.
    • Screening methods like family history, CPK levels, and muscle biopsy tests aid in identifying susceptible individuals.
    • Prophylactic oral dantrolene sodium can prevent MH crises in high-risk patients.