scholarly journals Dexmedetomidine as Part of Balanced Anesthesia Care in Children With Malignant Hyperthermia Risk and Egg Allergy

2011 ◽  
Vol 16 (2) ◽  
pp. 113-117
Author(s):  
Elisabeth Dewhirst ◽  
Aymen Naguib ◽  
Joseph D. Tobias
Keyword(s):  
Malignant Hyperthermia ◽  
Volatile Anesthetic ◽  
Anesthesia Care ◽  
Egg Allergy ◽  
Intravenous Anesthesia ◽  
Volatile Anesthetic Agent ◽  
Malignant Hyperthermia Susceptible ◽  
Balanced Anesthesia ◽  
Personal Histories ◽  
Anesthesia Technique

ABSTRACT Malignant hyperthermia is an acute hypermetabolic crisis triggered in susceptible patients by the administration of succinylcholine or a volatile anesthetic agent. When anesthesia care is provided to malignant hyperthermia-susceptible patients, a total intravenous anesthesia technique with propofol is frequently chosen. However, coexisting allergies to egg and soybeans may contraindicate the use of propofol. We present our experience with the use of dexmedetomidine as part of the anesthesia regimen in 3 patients with family histories of malignant hyperthermia and personal histories of egg or soybean allergies. In 2 patients, dexmedetomidine was used as part of a general anesthesia regimen and for sedation during spinal anesthesia in the third patient. Previous reports of the use of dexmedetomidine in patients susceptible to malignant hyperthermia are reviewed, and its benefits in such patients are discussed.

scholarly journals Preparation of Modern Anesthesia Workstations for Malignant Hyperthermia–susceptible Patients

2011 ◽  
Vol 114 (1) ◽  
pp. 205-212 ◽  
Author(s):  
Tae W. Kim ◽  
Michael E. Nemergut ◽  
David S. Warner
Keyword(s):  
Malignant Hyperthermia ◽  
Metabolic Response ◽  
Genetic Disorder ◽  
Volatile Anesthetic ◽  
The United States ◽  
Complex Nature ◽  
Minimum Concentration ◽  
Malignant Hyperthermia Susceptible ◽  
Anesthesia Machines ◽  
Anesthetic Gases

Patients with malignant hyperthermia experience an exaggerated metabolic response when exposed to volatile anesthetic gases and succinylcholine. The minimum concentration of anesthetic gas needed to trigger a malignant hyperthermia crisis in humans is unknown and may remain so because of the inherent risks associated with studying the complex nature of this rare and lethal genetic disorder. The Malignant Hyperthermia Association of the United States provides specific instructions on purging anesthesia machines of volatile agents to reduce the risk of exposure. However, these recommendations were developed from studies of older generation machines. Modern anesthesia workstations are more complex and contain more gas absorbing materials. A review of the literature found the current guidelines inadequate to prepare newer generation workstations, which require more time for purging anesthetic gases, autoclaving or replacement of parts, and modifications to the gas delivery system. Protocols must be developed to prepare newer generation anesthesia machines.

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.

scholarly journals Total Intravenous Anesthesia for Myocardial Protection and Preconditioning

2021 ◽  
Author(s):  
Minati Choudhury
Keyword(s):  
Protective Effect ◽  
Surgical Procedure ◽  
Myocardial Protection ◽  
Myocardial Injury ◽  
Volatile Anesthetic ◽  
Organ Protection ◽  
Intravenous Anesthesia ◽  
Intravenous Anesthetic ◽  
Anesthetic Agents ◽  
Anesthetic Preconditioning

AbstractPerioperative myocardial injury is common after any major surgical procedure even with best possible anesthesia and surgical management. Organ preservation during surgical procedure prevents morbidity and mortality. The effect of ischemic preconditioning on myocardial as well as other organ protection is well known. A variety of other agents also shown to have preconditioning thus protective effect on myocardium during anesthesia and surgery. The beneficial effect of volatile anesthetic preconditioning is well studied. However, the effect of intravenous anesthetic agents on this context is still way to go. This review is an attempt to look into the latest available research regarding the preconditioning and myocardial protective effect of intravenous anesthetic agents.

scholarly journals Functional Characterization of a Distinct Ryanodine Receptor Mutation in Human Malignant Hyperthermia-susceptible Muscle

1997 ◽  
Vol 272 (8) ◽  
pp. 5256-5260 ◽  
Author(s):  
Michael Richter ◽  
Lothar Schleithoff ◽  
Thomas Deufel ◽  
Frank Lehmann-Horn ◽  
Annegret Herrmann-Frank
Keyword(s):  
Malignant Hyperthermia ◽  
Ryanodine Receptor ◽  
Functional Characterization ◽  
Malignant Hyperthermia Susceptible

Balanced Anesthesia Using Sodium Oxybutyrate in Emergency Surgery

1980 ◽  
Vol 61 (5) ◽  
pp. 24-26
Author(s):  
A. D. Dzamukov
Keyword(s):  
Emergency Surgery ◽  
Surgical Patients ◽  
Acid Base Balance ◽  
Acid Base ◽  
Intravenous Anesthesia ◽  
Balanced Anesthesia ◽  
Base Balance

A method of intravenous anesthesia with sodium oxybutyrate in combination with drugs for neuroleptanalgesia and ataralgesia has been developed. The results of the use of anesthesia in 174 urgent surgical patients were analyzed. The normalization of acid-base balance under the influence of sodium oxybutyrate was noted.

Novel Variants Near the Central Domain of RYR1 in Two Malignant Hyperthermia-Susceptible Families from Taiwan

2009 ◽  
Vol 109 (4) ◽  
pp. 1273-1277 ◽  
Author(s):  
Po-Liang Chen ◽  
Yao-Wen Chang ◽  
Chun-Yu Chen ◽  
Yung-Chih Hsiang ◽  
Yuan-Ji Day
Keyword(s):  
Malignant Hyperthermia ◽  
Central Domain ◽  
Malignant Hyperthermia Susceptible ◽  
Novel Variants
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