title: Sevoflurane as a potential replacement for halothane in diagnostic testing for malignant hyperthermia susceptibility: results of a preliminary study.
abstract: BACKGROUND
  To diagnose malignant hyperthermia (MH) susceptibility, muscle bundles are exposed to halothane and caffeine. We investigated whether sevoflurane, which is more clinically relevant but less potent of an anesthetic, could replace halothane in diagnostic MH testing.
  
  
  METHODS
  With prior written consent, muscle bundles from 6 malignant hyperthermia susceptible (MHS) and 5 non-susceptible (MHN) individuals were exposed to increasing concentrations of sevoflurane (1.3; 2.6; 5.2 vol%). In addition, muscles from 9 MHS and 8 MHN were tested with a rapid exposure to 8 vol% of sevoflurane. Maximal contractures were measured and statistically analyzed (Mann-Whitney-U-test; P<0.05).
  
  
  RESULTS
  There were no differences in weight, length or pre-drug tension of the muscle bundles. Incremental sevoflurane concentrations induced no differences in contracture between susceptible and non-susceptible muscles. The rapid application of sevoflurane induced significant contractures in all malignant hyperthermia susceptible compared with non-susceptible individuals.
  
  
  CONCLUSIONS
  The rapid application of a high sevoflurane concentration but not an increasing stepwise application allowed for the diagnostic discrimination of susceptible individuals.
authors: Department of Anesthesiology, University Hospital Würzburg, Würzburg, Germany. tom.metterlein@gmx.net
authors: T
authors: T
authors: Metterlein
authors: E
authors: E
authors: Hartung
authors: F
authors: F
authors: Schuster
authors: N
authors: N
authors: Roewer
authors: M
authors: M
authors: Anetseder
mesh_terms: D018685:Anesthetics, Inhalation; D002110:Caffeine; D000697:Central Nervous System Stimulants; D004198:Disease Susceptibility / Q000175:diagnosis; D004305:Dose-Response Relationship, Drug; D006221:Halothane; D006801:Humans; D066298:In Vitro Techniques; D008305:Malignant Hyperthermia / Q000175:diagnosis*; D008738:Methyl Ethers; D009119:Muscle Contraction / Q000187:drug effects; D012132:Respiratory Muscles / Q000187:drug effects; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D000697:Central Nervous System Stimulants; D008738:Methyl Ethers; D000077149:Sevoflurane; D002110:Caffeine; D006221:Halothane