Ambulatory surgery and malignant hyperthermia.
OBJECTIVE
It is timely to review recent publications that add to our knowledge of malignant hyperthermia because we can go to the web or to newspapers and read of recent tragic malignant hyperthermia deaths.


RESULTS
New methods were used to affirm some of the previous observations regarding the epidemiology of malignant hyperthermia, and the well known North American Malignant Hyperthermia Registry was used to describe characteristics of malignant hyperthermia deaths. Anesthesia workstations have been found to have a larger reservoir of potent inhalation anesthetics than did their predecessors. Activated charcoal can assist in cleaning these machines. Genetic diagnosis of malignant hyperthermia susceptibility can sometimes be obtained from blood specimens. Work continues to increase the sensitivity of blood-based testing of malignant hyperthermia susceptibility.


CONCLUSIONS
Because malignant hyperthermia is potentially lethal, families should be evaluated as thoroughly as possible when an individual who claims to be malignant hyperthermia susceptible presents for elective surgery. Genetic testing may facilitate the evaluation of families with a very strong history of malignant hyperthermia. The use of activated charcoal can speed the removal of potent inhalation anesthetics from anesthesia workstations. This should facilitate the anesthetic care of malignant hyperthermia susceptible patients.
Brandom
Barbara W
BW
Department of Anesthesiology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15201, USA. brandombw@anes.upmc.edu
D000208:Acute Disease; D000554:Ambulatory Care Facilities; D000556:Ambulatory Surgical Procedures; D000758:Anesthesia; D020022:Genetic Predisposition to Disease; D006801:Humans; D007430:Intraoperative Care; D008305:Malignant Hyperthermia / Q000175:diagnosis / Q000628:therapy*; D010360:Patient Transfer; D011182:Postoperative Care