What medications used during anesthesia can provoke malignant hyperthermia syndrome?

The most common triggering agents are volatile anesthetic gases, such as halothane, sevoflurane, desflurane, isoflurane, enflurane or the depolarizing muscle relaxants suxamethonium and decamethonium used primarily in general anesthesia.

What is malignant hyperthermia during surgery?

Malignant hyperthermia is a severe reaction to certain drugs used for anesthesia. This severe reaction typically includes a dangerously high body temperature, rigid muscles or spasms, a rapid heart rate, and other symptoms. Without prompt treatment, the complications caused by malignant hyperthermia can be fatal.

What is the antidote for malignant hyperthermia?

Dantrolene is the only currently accepted specific treatment for MH. In an episode of MH, muscle metabolism is dramatically increased secondary to an increase in calcium within the muscle.

What can prevent the surprise of malignant hyperthermia during surgery?

Malignant hyperthermia can be prevented by avoiding the agents that bring it about: succinylcholine (Anectine®) and inhalational agents. Alternatives are readily available and can be substituted easily.

What can trigger malignant hyperthermia?

Malignant hyperthermia is a severe reaction to a dose of anesthetics. The reaction is sometimes fatal. It is caused by a rare, inherited muscle abnormality. Infrequently, extreme exercise or heat stroke can trigger malignant hyperthermia in someone with the muscle abnormality.

What disease is most associated with malignant hyperthermia?

The most common of these conditions are Duchenne and Becker muscular dystrophy. Although rhabdomyolysis with hyperkalemia can be a feature of MH, the MH syndrome usually manifests signs of hypermetabolism, such as respiratory acidosis, metabolic acidosis, and excessive heat production.

What drugs should be avoided in malignant hyperthermia?

What drugs trigger MH? All the inhalation anesthetics (desflurane, sevoflurane, isoflurane, methoxyflurane halothane, enflurane) and succinylcholine (a depolarizing muscle relaxant) are considered MH triggers.

Which drugs cause malignant hyperthermia?

Triggering Agents According to the Malignant Hyperthermia Association of the United States (MHAUS), the following agents approved for use in the U.S. are known triggers of MH: inhaled general anesthetics, halothane, desflurane, enflurane, ether, isoflurane, sevoflurane, and succinylcholine.

What is one way to prepare the operating room for malignant hyperthermia?

The authors concluded anesthesia machines should be prepared by removing the vaporizers, flushing with high-flow oxygen for 15 min, and using circuit tubing, gas outlet hoses, and carbon dioxide absorbent never exposed to anesthetic gases.

How long after surgery can malignant hyperthermia occur?

Although the initial clinical signs of MH typically occur within one hour of anesthesia induction, the onset of MH can occur any time during the administration of triggering agents.

What can be mistaken for malignant hyperthermia?

In addition to the conditions listed in the differential diagnosis, there are a number of other conditions and circumstances that may mimic malignant hyperthermia (MH), including the following: Contrast dye. Diabetic coma. Drug toxicity.

How long after anesthesia can malignant hyperthermia occur?

What is the drug of choice for malignant hyperthermia?

Dantrolene sodium, the only available medical treatment for malignant hyperthermia. The current treatment of choice is the intravenous administration of dantrolene, the only known antidote, discontinuation of triggering agents, and supportive therapy directed at correcting hyperthermia, acidosis, and organ dysfunction.

What drugs trigger MH?

Unsafe drugs for MH susceptibles are the depolarizing muscle relaxant, succinylcholine (Anectine), and the potent inhalation agents (sevoflurane, desflurane, isoflurane, halothane, and enflurane). Older inhalational anesthetics such as ether, cyclopropane and methoxyflurane can also trigger an MH crisis.

Are you prepared for malignant hyperthermia?

If you have a family history of malignant hyperthermia or have a family member who has problems with anesthesia, tell your surgeon and anesthesiologist prior to surgery. This step allows your doctors to prepare for and respond quickly to any reactions. A drug called dantrolene (Dantrium) is used to treat the reaction.

How can malignant hyperthermia be prevented?

How can malignant hyperthermia be prevented? Breeders can prevent malignant hyperthermia by avoiding mating horses with the causative mutation. Since this disease has an autosomal dominant mode of inheritance, only one copy of the disease allele is needed for a horse to be affected. DNA samples can be submitted to the UC Davis Veterinary Genetics Laboratory for testing. This genetic test is also part of the AQHA 5-panel testing requirements for breeding animals.