The severity of sevoflurane‐induced malignant hyperthermia

Migita, Takako; Mukaida, Keiko; Kobayashi, Masako; Hamada, Hiroshi; Kawamoto, Masashi

doi:10.1111/j.1399-6576.2011.02573.x

Cited by 23 publications

(28 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The median time between onset of the first clinical sign and dantrolene administration was 20 minutes (IQR, [15][16][17][18][19][20], with a range of 12 to 70 minutes (IQR, 15-25). The median time between onset of the first clinical sign and dantrolene administration was 20 minutes (IQR, [15][16][17][18][19][20], with a range of 12 to 70 minutes (IQR, 15-25).…”

Section: Resultsmentioning

confidence: 99%

“…In contrast to the previous studies, which used the CGS rankings of "very likely" or "almost certain" as measures for likelihood of MH events, 7,13 in our retrospective study positive CHCT results were used as a part of the inclusion criteria to confirm MHS status of selected patients. In addition, our study was Group with complication Group without complication P = 0.005 c 23.5 15 [15][16][17][18][19][20] CGS = Clinical Grading Scale; Succ = succinylcholine; IQR = interquartile range. 11 Due to the stringent inclusion criteria, only 129 MH patients of 373 cases were included in the study.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Malignant Hyperthermia in Canada

Riazi

Larach²,

et al. 2014

Anesthesia &Amp; Analgesia

124

View full text Add to dashboard Cite

This is the first Canadian study in 3 decades to report nationwide data on MH epidemiology. Features that differ from earlier reports include a 15.5% incidence of reactions triggered by succinylcholine alone and lower complication rates. In agreement with previously published studies, we confirmed in this independent dataset that increased complication rates were associated with an increased time interval between the first adverse clinical sign and dantrolene treatment. This underscores the need for early diagnosis and rapid dantrolene access and administration in anesthetizing locations using either succinylcholine or volatile anesthetic drugs.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Malignant Hyperthermia in Canada

Riazi

Larach²,

et al. 2014

Anesthesia &Amp; Analgesia

124

View full text Add to dashboard Cite

show abstract

“…For instance, Hopkins and colleagues reported, that in susceptible patients the onset of MH was statistically significant faster after halothane exposure compared to enflurane or sevoflurane [5]. Equally, fulminant MH episodes after isoflurane, sevoflurane or desflurane seem to occur with temporal delay [20,21], while halothane may induce MH within minutes [5]. In MHS animals, similar results were seen after intramuscular injection of halothane or sevoflurane.…”

Section: Discussionmentioning

confidence: 89%

Evaluation of suspected malignant hyperthermia events during anesthesia

et al. 2013

View full text Add to dashboard Cite

BackgroundMalignant hyperthermia (MH), a metabolic myopathy triggered by volatile anesthetics and depolarizing muscle relaxants, is a potentially lethal complication of general anesthesia in susceptible patients. The implementation of modern inhalation anesthetics that research indicates as less potent trigger substances and the recommended limitations of succinylcholine use, suggests there may be considerable decline of fulminant MH cases. In the presented study, the authors analyzed suspected MH episodes during general anesthesia of patients that were referred to the Wuerzburg MH unit between 2007 and 2011, assuming that MH is still a relevant anesthetic problem in our days.MethodsWith approval of the local ethics committee data of patients that underwent muscle biopsy and in vitro contracture test (IVCT) between 2007 and 2011 were analyzed. Only patients with a history of suspected MH crisis were included in the study. The incidents were evaluated retrospectively using anesthetic documentation and medical records.ResultsBetween 2007 and 2011 a total of 124 patients were tested. 19 of them were referred because of suspected MH events; 7 patients were diagnosed MH-susceptible, 4 MH-equivocal and 8 MH-non-susceptible by IVCT. In a majority of cases masseter spasm after succinylcholine had been the primary symptom. Cardiac arrhythmias and hypercapnia frequently occurred early in the course of events. Interestingly, dantrolene treatment was initiated in a few cases only.ConclusionsMH is still an important anesthetic complication. Every anesthetist must be aware of this life-threatening syndrome at any time. The rapid onset of adequate therapy is crucial to avoid major harm and possibly lethal outcome. Dantrolene must be readily available wherever MH triggering agents are used for anesthesia.

show abstract

“…Abortive reactions (e.g. the reaction settling after withdrawal of the volatile, cooling, or just settling at the end of the anaesthetic following close observation but no dantrolene administered) have been described 1,[19][20][21][22] . Only 56% of NZ reactions have received dantrolene.…”

Section: Relevance Of Family History and Record Keepingmentioning

confidence: 99%

Evidence of Malignant Hyperthermia in Patients Administered Triggering Agents before Malignant Hyperthermia Susceptibility Identified: Missed Opportunities Prior to Diagnosis

Bulger

Stowell

et al. 2017

Anaesth Intensive Care

View full text Add to dashboard Cite

Malignant hyperthermia (MH) is a hypermetabolic disorder of skeletal muscle triggered almost exclusively by potent inhalational agents and suxamethonium. Signs of an MH reaction are non-specific and may be confused with the presentation of other problems such as sepsis and overheating of a patient. A high index of suspicion is needed to be aware of an early presentation of MH. Nine patients are presented who showed abnormal signs with an earlier anaesthetic where the possible diagnosis of an MH reaction was missed. These patients either presented later with an MH reaction, confirmed by DNA analysis and in some cases in vitro contracture testing, or were diagnosed by the identification of a causative mutation confirming MH susceptibility. The MH clinical grading scale is helpful in determining the likelihood that clinical indicators indicate a possible MH reaction. Masseter muscle rigidity is a known sign of MH, confirmed in this report by positive in vitro contracture testing and DNA analysis. Several uncommon muscle disorders have a high association with MH, and postoperative myalgia unrelated to suxamethonium can be a sign which is associated with MH. These reports emphasise the importance of a thorough family history (as the MH status was known by the family in four patients), a high index of suspicion for MH, and documentation of the possibility of MH susceptibility in the anaesthesia record.

show abstract

The severity of sevoflurane‐induced malignant hyperthermia

Abstract: There were no clinically apparent differences between MH triggered by sevoflurane and isoflurane, and thus no evidence to support the postulate that sevoflurane is a weak or weaker MH triggering agent.

Cited by 23 publications

References 18 publications

Malignant Hyperthermia in Canada

Malignant Hyperthermia in Canada

Evaluation of suspected malignant hyperthermia events during anesthesia

Evidence of Malignant Hyperthermia in Patients Administered Triggering Agents before Malignant Hyperthermia Susceptibility Identified: Missed Opportunities Prior to Diagnosis

Contact Info

Product

Resources

About