Background: Malignant hyperthermia (MH), a metabolic myopathy triggered by volatile anesthetics and\r\ndepolarizing muscle relaxants, is a potentially lethal complication of general anesthesia in susceptible patients. The\r\nimplementation of modern inhalation anesthetics that research indicates as less potent trigger substances and the\r\nrecommended limitations of succinylcholine use, suggests there may be considerable decline of fulminant MH\r\ncases. In the presented study, the authors analyzed suspected MH episodes during general anesthesia of patients\r\nthat were referred to the Wuerzburg MH unit between 2007 and 2011, assuming that MH is still a relevant\r\nanesthetic problem in our days.\r\nMethods: With approval of the local ethics committee data of patients that underwent muscle biopsy and in vitro\r\ncontracture test (IVCT) between 2007 and 2011 were analyzed. Only patients with a history of suspected MH crisis\r\nwere included in the study. The incidents were evaluated retrospectively using anesthetic documentation and\r\nmedical records.\r\nResults: Between 2007 and 2011 a total of 124 patients were tested. 19 of them were referred because of\r\nsuspected MH events; 7 patients were diagnosed MH-susceptible, 4 MH-equivocal and 8 MH-non-susceptible by\r\nIVCT. In a majority of cases masseter spasm after succinylcholine had been the primary symptom. Cardiac\r\narrhythmias and hypercapnia frequently occurred early in the course of events. Interestingly, dantrolene treatment\r\nwas initiated in a few cases only.\r\nConclusions: MH is still an important anesthetic complication. Every anesthetist must be aware of this lifethreatening\r\nsyndrome at any time. The rapid onset of adequate therapy is crucial to avoid major harm and possibly\r\nlethal outcome. Dantrolene must be readily available wherever MH triggering agents are used for anesthesia.
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