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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 ]
There is no specific treatment for central core disease. Certain triggering anesthetics must be avoided, and relatives should be screened for RYR1 mutations that cause malignant hyperthermia. [2] Research has shown that some patients may benefit from treatment with oral salbutamol. [6] [7]
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]
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.
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.
Isoflurane, sold under the brand name Forane among others, is a general anesthetic. [4] It can be used to start or maintain anesthesia; however, other medications are often used to start anesthesia, due to airway irritation with isoflurane. [3] [5] Isoflurane is given via inhalation. [4]
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.