A minimally invasive metabolic test with intramuscular injection of halothane 5 and 6 vol% to detect probands at risk for malignant hyperthermia.
We hypothesised that intramuscular halothane injection increases local Pco(2) concentrations in malignant hyperthermia susceptible (MHS) but not in non-susceptible (MHN) individuals. Pco(2) probes with attached microtubing catheters for halothane injection were placed into the lateral vastus muscle of eight MHS and eight MHN probands. Following equilibration, a single bolus of 200 microl halothane 5 and 6 vol% was injected. Pco(2) was measured spectrophotometrically. Baseline Pco(2) concentrations were similar between groups. Maximum Pco(2) and maximum rate of Pco(2) increase was significantly enhanced by halothane 5 and 6 vol% in MHS compared to MHN probands. Systemic haemodynamic and metabolic parameters did not differ between both groups. Local halothane application induces a hypermetabolic reaction with a significant Pco(2) increase in MHS compared to MHN probands, indicating a susceptibility to malignant hyperthermia. Intramuscular halothane injection with Pco(2) measurement seems to be a suitable method for the development of a minimally invasive metabolic test to diagnose malignant hyperthermia susceptibility.
Schuster
F
F
University of Würzburg, Department of Anaesthesiology, Oberdürrbacher Strasse 6, D-97080 Würzburg, Germany. schuster_f@klinik.uni-wuerzburg.de
Gardill
A
A
Metterlein
T
T
Kranke
P
P
Roewer
N
N
Anetseder
M
M
D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D004198:Disease Susceptibility; D005260:Female; D006221:Halothane / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008305:Malignant Hyperthermia / Q000097:blood / Q000175:diagnosis*; D008875:Middle Aged; D009211:Myoglobin / Q000097:blood; D010313:Partial Pressure
D018685:Anesthetics, Inhalation; D009211:Myoglobin; D002245:Carbon Dioxide; D003402:Creatine Kinase; D006221:Halothane