Malignant hyperthermia: considerations for the general surgeon.
Malignant hyperthermia is a potentially fatal genetic myopathy that presents when the patient is under anesthesia. It manifests as a hypermetabolic state involving tachycardia, hypercarbia, base deficit, rigidity and fever. Many of the hallmark traits of an acute malignant hyperthermic crisis overlap with signs and symptoms of an emergent abdominal condition. Historically, there has been a reluctance in local community hospitals to manage patients known to be susceptible to malignant hyperthemia, and this is a source of frustration for many families in which there is a history of this condition. This article outlines the diagnosis and management of an acute malignant hyperthermic crisis from the viewpoint of a community general surgeon and provides a review of the management of patients known to be susceptible to this condition in the surgeon's elective and emergent practice.
Heggie
Jane E
JE
Department of Anesthesia, Toronto General Hospital, University Health Network, Ont. jane.heggie@uhn.on.ca
D018685:Anesthetics, Inhalation / Q000009:adverse effects; D001706:Biopsy; D003620:Dantrolene / Q000627:therapeutic use; D013502:General Surgery; D020022:Genetic Predisposition to Disease; D006801:Humans; D008305:Malignant Hyperthermia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D008991:Monitoring, Physiologic / Q000379:methods; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D018482:Muscle, Skeletal / Q000473:pathology; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects
D018685:Anesthetics, Inhalation; D009125:Muscle Relaxants, Central; D003473:Neuromuscular Nondepolarizing Agents; D003620:Dantrolene