title: Succinylcholine in malignant hyperthermia: evaluation of a novel in vivo model.
abstract: BACKGROUND
  Malignant hyperthermia (MH) is a potentially lethal anesthetic complication characterized by muscle hypermetabolism and generalized rigor. The exact mechanism of succinylcholine as an MH trigger cannot be examined in existing in vitro models. Therefore, a novel in vivo model was used to examine the metabolic response to succinylcholine.
  
  
  METHODS
  With institutional review board approval, 6 MH susceptible (MHS) and 6 MH non-susceptible (MHN) pigs were anesthetized with hemodynamic and systemic metabolic monitoring. Microdialysis catheters were placed intramuscularly. After equilibration, succinylcholine, halothane, and Ringer solution were injected. Lactate was measured in the dialysate and statistically analyzed by Mann-Whitney U-test (significance level P < 0.05).
  
  
  RESULTS
  Hemodynamic and systemic metabolic parameters were not different between the groups throughout the experiment. In the MHS pigs, halothane induced a significant increase of lactate. In MHN pigs, no substance induced a reaction.
  
  
  CONCLUSIONS
  Halothane, but not succinylcholine, induced a hypermetabolic reaction in this model. Therefore, the role of succinylcholine as an MH trigger remains questionable.
authors: Department of Anesthesiology, University Hospital Würzburg, Würzburg, Germany. tom.metterlein@gmx.net
authors: Thomas
authors: T
authors: Metterlein
authors: Frank
authors: F
authors: Schuster
authors: Elise
authors: E
authors: Palmer
authors: Norbert
authors: N
authors: Roewer
authors: Martin
authors: M
authors: Anetseder