Anesthetic Drugs and Onset of Malignant Hyperthermia

2014 ◽  
Vol 118 (2) ◽  
pp. 388-396 ◽  
Author(s):  
Mihaela Visoiu ◽  
Michael C. Young ◽  
Keith Wieland ◽  
Barbara W. Brandom
Keyword(s):  
Malignant Hyperthermia ◽  
Anesthetic Drugs

Anesthetic Drugs and Onset of Malignant Hyperthermia

2014 ◽  
Vol 58 (5) ◽  
pp. 244-245
Author(s):  
Mihaela Visoiu ◽  
Michael C. Young ◽  
Keith Wieland ◽  
Barbara W. Brandom
Keyword(s):  
Malignant Hyperthermia ◽  
Anesthetic Drugs

scholarly journals Prevalence of Malignant Hyperthermia and Relationship with Anesthetics in Japan

2011 ◽  
Vol 114 (1) ◽  
pp. 84-90 ◽  
Author(s):  
Masahiko Sumitani ◽  
Kanji Uchida ◽  
Hideo Yasunaga ◽  
Hiromasa Horiguchi ◽  
Yoshiomi Kusakabe ◽  
...  
Keyword(s):  
Malignant Hyperthermia ◽  
General Anesthesia ◽  
Hospital Death ◽  
Diagnosis Procedure Combination ◽  
Anesthetic Drugs ◽  
Causative Agents ◽  
Life Threatening ◽  
Relationship Of ◽  
The Relationship ◽  
Actual Prevalence

Background Malignant hyperthermia (MH) is a rare but life-threatening disease that occurs during general anesthesia. The actual prevalence of MH remains unclear, and the association between MH and various anesthetic drugs remains controversial because of a lack of universal reporting. Methods Using the Japanese Diagnosis Procedure Combination database, we collected data of inpatients who had general anesthesia between July and December 2006-2008. Patients' age, gender, diagnoses, procedures, and the use of drugs during anesthesia, including volatile agents, muscle relaxants, and propofol, were investigated. Univariate comparisons were made to examine the relationship of each anesthetic drug or demographic factor with the occurrence of MH. Results Of 1,238,171 surgical patients undergoing general anesthesia, we identified 17 MH patients. Only one in-hospital death was identified. Men were significantly more likely to contract MH(odds ratio: 3.49; 95% CI 1.14 -10.7; P=0.029). No MH patient was found among 19,871 suxamethonium users. The prevalence of MH was relatively high in users of sevoflurane and rocuronium compared with nonusers but was not statistically significant [corrected].. Conclusions No single drug was significantly associated with the occurrence of MH. Data should be continuously compiled, and further analyses with larger numbers of cases are necessary to identify possible causative agents.

scholarly journals Voltage modulates halothane-triggered Ca2+ release in malignant hyperthermia-susceptible muscle

2017 ◽  
Vol 150 (1) ◽  
pp. 111-125 ◽  
Author(s):  
Alberto Zullo ◽  
Martin Textor ◽  
Philipp Elischer ◽  
Stefan Mall ◽  
Andreas Alt ◽  
...  
Keyword(s):  
Membrane Potential ◽  
Malignant Hyperthermia ◽  
Time Course ◽  
Voltage Dependence ◽  
Muscle Fibers ◽  
Volatile Anesthetic ◽  
Resting Membrane Potential ◽  
Drug Induced ◽  
Anesthetic Drugs ◽  
Malignant Hyperthermia Susceptible

Malignant hyperthermia (MH) is a fatal hypermetabolic state that may occur during general anesthesia in susceptible individuals. It is often caused by mutations in the ryanodine receptor RyR1 that favor drug-induced release of Ca2+ from the sarcoplasmic reticulum. Here, knowing that membrane depolarization triggers Ca2+ release in normal muscle function, we study the cross-influence of membrane potential and anesthetic drugs on Ca2+ release. We used short single muscle fibers of knock-in mice heterozygous for the RyR1 mutation Y524S combined with microfluorimetry to measure intracellular Ca2+ signals. Halothane, a volatile anesthetic used in contracture testing for MH susceptibility, was equilibrated with the solution superfusing the cells by means of a vaporizer system. In the range 0.2 to 3%, the drug causes significantly larger elevations of free myoplasmic [Ca2+] in mutant (YS) compared with wild-type (WT) fibers. Action potential–induced Ca2+ signals exhibit a slowing of their time course of relaxation that can be attributed to a component of delayed Ca2+ release turnoff. In further experiments, we applied halothane to single fibers that were voltage-clamped using two intracellular microelectrodes and studied the effect of small (10-mV) deviations from the holding potential (−80 mV). Untreated WT fibers show essentially no changes in [Ca2+], whereas the Ca2+ level of YS fibers increases and decreases on depolarization and hyperpolarization, respectively. The drug causes a significant enhancement of this response. Depolarizing pulses reveal a substantial negative shift in the voltage dependence of activation of Ca2+ release. This behavior likely results from the allosteric coupling between RyR1 and its transverse tubular voltage sensor. We conclude that the binding of halothane to RyR1 alters the voltage dependence of Ca2+ release in MH-susceptible muscle fibers such that the resting membrane potential becomes a decisive factor for the efficiency of the drug to trigger Ca2+ release.

Current Concepts of Malignant Hyperthermia

1981 ◽  
Vol 89 (6) ◽  
pp. 891-897 ◽  
Author(s):  
Bruce W. Jafek ◽  
C.C. Solomons ◽  
N.C. Masson ◽  
M.C. Mahowald ◽  
T.F. Gumprecht
Keyword(s):  
Malignant Hyperthermia ◽  
Respiratory Acidosis ◽  
Rapid Identification ◽  
Muscle Relaxants ◽  
Susceptible Individual ◽  
General Anesthetic ◽  
Dantrolene Sodium ◽  
Anesthetic Drugs ◽  
Chemically Induced ◽  
Bioassay Test

Malignant hyperthermia (MH) is a chemically induced, genetic myopathy characterized by metabolic and respiratory acidosis, arrhythmias, hyperpyrexia, and muscular rigidity usually occurring during or within 24 hours postanesthesia. It is initiated by some anesthetic drugs, muscle relaxants, and possibly by catecholamines produced by stress. The incidence of the disease is 1:15,000 in populations who have received a general anesthetic. A recently developed platelet bioassay test allows for rapid identification of the susceptible individual, while medication with dantrolene sodium can usually prevent or reverse the syndrome.

Malignant Hyperthermia

1991 ◽  
Vol 3 (1) ◽  
pp. 129-134
Author(s):  
Ginger Schafer Wlody
Keyword(s):  
Malignant Hyperthermia

Malignant hyperthermia susceptibility: utilization of genetic results in an electronic medical record to increase safety

2020 ◽  
Vol 21 (17) ◽  
pp. 1207-1215
Author(s):  
Jordan F Baye ◽  
Natasha J Petry ◽  
Shauna L Jacobson ◽  
Michelle M Moore ◽  
Bethany Tucker ◽  
...  
Keyword(s):  
Decision Support ◽  
Malignant Hyperthermia ◽  
Clinical Decision Support ◽  
Perioperative Complications ◽  
Implementation Strategies ◽  
Clinical Decision ◽  
Lessons Learned ◽  
Malignant Hyperthermia Susceptibility ◽  
Alert System ◽  
Genotyping Platform

Aim: This manuscript describes implementation of clinical decision support for providers concerned with perioperative complications of malignant hyperthermia susceptibility. Materials & methods: Clinical decision support for malignant hyperthermia susceptibility was implemented in 2018 based around our pre-emptive genotyping platform. We completed a brief descriptive review of patients who underwent pre-emptive testing, focused particularly on RYR1 and CACNA1S genes. Results: To date, we have completed pre-emptive genetic testing on more than 10,000 patients; 13 patients having been identified as a carrier of a pathogenic or likely pathogenic variant of RYR1 or CACNA1S. Conclusion: An alert system for malignant hyperthermia susceptibility – as an extension of our pre-emptive genomics platform – was implemented successfully. Implementation strategies and lessons learned are discussed herein.

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