No response to trigger agents in a malignant hyperthermia-susceptible patient.
Malignant hyperthermia susceptibility is an inherited disorder, where a life-threatening condition can result from exposure to a trigger agent or agents. Succinylcholine and volatile anaesthetic agents are well established to be trigger agents in anaesthetic practice. We describe a case of a previously investigated malignant hyperthermia-susceptible patient who did not declare his status and was exposed to both succinylcholine and isoflurane, without any detectable reaction. Possible explanations for the lack of reaction include a subnormal temperature when exposed to isoflurane, and a significant interval between exposure to succinylcholine and isoflurane. Absence of a reaction to trigger agents on this occasion is not thought to indicate an incorrect diagnosis and labelling.
Claxton
B A
BA
Department of Anaesthesia, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK.
Cross
M H
MH
Hopkins
P M
PM
D000328:Adult; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D001831:Body Temperature; D004198:Disease Susceptibility; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects*; D008297:Male; D008305:Malignant Hyperthermia / Q000209:etiology*; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects*; D013390:Succinylcholine / Q000009:adverse effects*
D018685:Anesthetics, Inhalation; D009467:Neuromuscular Depolarizing Agents; D007530:Isoflurane; D013390:Succinylcholine