Malignant hyperthermia is a pharmacogenetic disease caused by exposure to certain drugs and muscle relaxants used in general anesthesia in people with a tendency.
It has been shown that the primary defect is in the "Ryanodin" receptors located in the sarcoplasmic reticulum of the skeletal muscle cell.
In malignant hyperthermia, calcium secretion is impaired as well as its pumping back.
It is more common in young men.
Some musculoskeletal diseases are usually seen in patients sensitive to malignant hyperthermia. patients diagnosed with kyphoscoliosis, ptosis, habitual dislocations, umbilical and hiatal hernias, undescended testis, osteogenesis imperfecta and muscular dystrophy.
Previous uneventful anesthesia does not exclude the risk of malignant hyperthermia.
These are findings related to hypermetabolism.
Increased CO production and oxygen use, tachycardia, fever, labile blood pressure, increased skeletal muscle tone. Trismus is a typical finding during intubation.
Noninvasive tests include measuring EMG, creatine phosphokinase, lactic dehydrogenase, ATP, creatinophosphate levels, and detecting intracellular calcium uptake of lymphocytes exposed to halothane.
The most reliable method in the diagnosis of malignant hyperthermia is muscle biopsy and halothane caffeine contracture test.
In case of suspected malignant hyperthermia, cooling of the patient is started and triggering agents are discontinued. The patient is hyperventilated with pure oxygen and metabolic acidosis is tried to be prevented.
Specific treatment is with dantrolene sodium.
It is considered to inhibit calcium release from the sarcoplasmic reticulum.
Diuresis is provided to prevent kidney problems due to myoglobinuria.
Dantrolene prophylaxis should be performed before starting anesthesia in patients who are thought to have a tendency to malignant hyperthermia. For this purpose, preoperative IV dantrolene infusion is started.