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Related Experiment Videos

Norepinephrine does not potentiate porcine malignant hyperthermia

R M Maccani1, D J Wedel, R E Hofer

  • 1Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.

Anesthesia and Analgesia
|April 1, 1996
PubMed
Summary

Norepinephrine does not trigger malignant hyperthermia (MH) in susceptible swine. High-dose norepinephrine infusion did not affect MH onset time, suggesting it does not initiate or accelerate MH episodes.

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Genetics

Background:

  • Malignant hyperthermia (MH) is a rare, life-threatening genetic disorder triggered by specific anesthetic agents.
  • The role of norepinephrine (NE) in MH pathophysiology remains controversial.
  • Susceptible individuals experience hypermetabolism, hyperthermia, and muscle rigidity upon exposure to triggering drugs.

Purpose of the Study:

  • To investigate whether norepinephrine (NE) initiates or accelerates malignant hyperthermia (MH) in susceptible swine.
  • To determine the effect of exogenous NE on MH onset during halothane anesthesia.
  • To compare the impact of NE infusion versus intra-aortic balloon pump (IABP) support on MH triggering.

Main Methods:

  • MH-susceptible swine were exposed to halothane (2% MAC) for 60 minutes.

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  • Three groups were studied: no treatment, NE infusion (8 µg/kg/min), and IABP support.
  • Plasma NE and epinephrine levels, along with physiological parameters (pHa, lactate, PaCO2, temperature, MAP), were monitored.

    • Main Results:

    • All animals developed MH; no significant differences in core MH parameters (pHa, lactate, PaCO2, temperature) were observed between groups.
    • Time to MH trigger was longer in the untreated group compared to NE and IABP groups.
    • NE infusion increased plasma NE and epinephrine levels without altering MH onset time; IABP maintained mean arterial pressure (MAP) but did not increase epinephrine.
    • Severe reduction in MAP was associated with delayed MH onset.

    Conclusions:

    • Exogenous norepinephrine does not enhance MH triggering in susceptible swine.
    • High-dose NE infusion does not affect the time to MH onset.
    • Maintaining mean arterial pressure (MAP) with IABP did not influence MH trigger time compared to NE infusion.
    • Severe hypotension appears to delay the onset of MH in susceptible swine.