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Malignant hyperthermia (MH) is a type of severe reaction that occurs in response to particular medications used during general anesthesia, among those who are susceptible. [1] Symptoms include muscle rigidity , fever , and a fast heart rate . [ 1 ]
Certain physiological and pathological states may alter MAC. For example, MAC increases with hyperthermia and hypernatremia. Conversely, anemia, hypercarbia, hypoxia, hypothermia, hypotension (MAP < 40 mmHg), and pregnancy seem to decrease MAC. Duration of anesthesia, gender seem to have little effect on MAC. [8] Age has been shown to affect MAC.
Halothane sensitises the heart to catecholamines, so it is liable to cause cardiac arrhythmia, occasionally fatal, particularly if hypercapnia has been allowed to develop. This seems to be especially problematic in dental anesthesia. [25] Like all the potent inhalational anaesthetic agents, it is a potent trigger for malignant hyperthermia. [5]
Recreational drugs such as amphetamines [17] and cocaine, [18] PCP, dextromethorphan, LSD, and MDMA may cause hyperthermia. [2] Malignant hyperthermia is a rare reaction to common anesthetic agents (such as halothane) or the paralytic agent succinylcholine. Those who have this reaction, which is potentially fatal, have a genetic predisposition. [2]
Malignant hyperthermia and malignant catatonia share features of autonomic instability, hyperthermia, and rigidity. However, malignant hyperthermia is a hereditary disorder of skeletal muscle that makes these patients susceptible to exposure to halogenated anesthetics and/or depolarizing muscle relaxants like succinylcholine. [53]
An outgrowth of this committee, the Anesthesia Patient Safety Foundation, was created in 1985 as an independent, nonprofit corporation with the goal "that no patient shall be harmed by anesthesia". [73] The rare but major complication of general anaesthesia is malignant hyperthermia.
If nicotinic receptors of the autonomic ganglia or adrenal medulla are blocked, these drugs may cause autonomic symptoms. Also, neuromuscular blockers may facilitate histamine release, which causes hypotension, flushing, and tachycardia. Succinylcholine may also trigger malignant hyperthermia in rare cases in patients who may be susceptible.
Antipsychotic medications may cause neuroleptic malignant syndrome, which can cause severe muscle rigidity with rhabdomyolysis and hyperpyrexia; Neuromuscular blocking agents used in anesthesia may result in malignant hyperthermia, also associated with rhabdomyolysis; Medications that cause serotonin syndrome, such as SSRIs