Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-05-15T05:43:42.666Z Has data issue: false hasContentIssue false
  • English
  • Français

Prospective management of malignant hyperthermia in the otolaryngological patient

Published online by Cambridge University Press:  29 June 2007

Phillip Ashley Wackym  and
Imad H. Abdul-Rasool
Phillip Ashley Wackym
Affiliation:
From the Division of Head and Neck Surgery, Malignant Hyperthermia Research Center, Department of Anesthesia
Imad H. Abdul-Rasool*
Affiliation:
Division of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, CA 90024.
*
Imad H. Abdul-Rasool, M.D., Ph.D., Director, Malignant Hyperthermia Center, UCLA Hospital, Los Angeles, CA 90024, U.S.A.
Get access Rights & Permissions [Opens in a new window]

Abstract

Malignant hyperthermia (MH) is a seemingly rare genetic myopathy. Hypermetabolic crises accompanied by a rise in body temperature to as high as 44°C are its hallmark. These are usually triggered by potent inhalation anesthetics or depolarizing muscle relaxants. Because of the extraordinary risk of death in patients who are at risk, otolaryngologists may be reluctant to operate on these patients. Ten such patients undergoing tonsillectomy and adenoidectomy, myringotomy with ventilation tube insertion, and nasal polypectomy were anesthetized with nitrous oxide, barbiturates, opiates, tranquilizers and non-depolarizing muscle relaxants without complication. The patients were not treated prophylactically with dantrolene. Cardiac monitoring and rectal temperatures were followed. All ten patients had vastus lateralis muscle biopsy performed and subsequent caffeine/halothane contracture studies completed. The contracture study was positive in eight out of the patients studied. No anesthetic or surgical complications were encountered. This study demonstrates that patients at risk of developing MH crisis can have otolaryngologic procedures performed safely while undergoing appropriately selected general anesthesia.

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 102 , Issue 6 , June 1988 , pp. 513 - 516
Copyright
Copyright © JLO (1984) Limited 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Britt, B. A. (1985) Malignant hyperthermia. Canadian Anaesthetists' Society Journal, 32: 666–677.CrossRefGoogle ScholarPubMed
Britt, B. A. and Kalow, W. (1970) Malignant hyperthermia: A statistical review. Canadian Anaesthetists' Journal, 17: 293–315.CrossRefGoogle ScholarPubMed
Britt, B. A., McComas, A. J., Endrenyi, L. and Kalow, W. (1977) Motor unit counting and the caffeine contracture test in malignant hyperthermia. Anesthesiology, 47: 490–497.Google Scholar
Britt, B. A., Scott, E., Frodis, W., Clements, M. J. and Endrenyi, L. (1984) Dantrolene—in vitro studies in malignant hyperthermia susceptible (MHS) and normal skeletal muscle. Canadian Anaesthetists' Society Journal, 31: 130–154.CrossRefGoogle ScholarPubMed
Denborough, M. A. and Lovell, R. R. H. (1960) Anaesthetic deaths in a family (letter to the editor). Lancet, 2: 45.Google Scholar
Gallant, E. M. and Anhern, C. P. (1983) Malignant hyperthermia: Responses of skeletan muscle to general anesthetic. Mayo Clinic Proceedings, 58: 758–763.Google Scholar
Gronert, G. A. (1980) Malignant hyperthermia. Anesthesiology, 53: 395–423.CrossRefGoogle ScholarPubMed
Gronert, G. A. (1986) Malignant hyperthermia, in Miller, R. D. (ed.), Anesthesia. New York, Churchill Livingstone, pp. 1971–1994.Google Scholar
Huckell, V. F., Staniloff, H. M., Britt, B. A., Waxman, M. B. and Morch, J. E. (1978) Cardiac manifestations of malignant hyperthermia susceptibility. Circulation, 58: 916–925.Google Scholar
Jardon, O. M., Wingard, D. W., Barak, A. J. and Connolly, J. F. (1979) Malignant hyperthermia. A potentially fatal syndrome in orthopaedic patients. Journal of Bone and Joint Surgery, 61-A: 1064–1070.Google Scholar
Kalow, W., Britt, B. A. and Chan, F-Y (1979) Epidemiology and inheritance of malignant hyperthermia. International Anesthesiology Clinics, 17: 119–140.Google Scholar
Pollock, R. A. and Britt, B. A. (1983) Malignant hyperthermia in the head and neck patient: An update and review. Laryngoscope, 93: 318–325.Google Scholar
Ruhland, G. and Hinkle, A. J. (1984) Malignant hyperthermia after oral loading and intravenous pretreatment with dantrolene n i a patient susceptible to malignant hyperthermia. Anesthesiology, 60: 159–160.CrossRefGoogle Scholar
Watson, C. B., Reierson, N. and Norfelect, E. A. (1986) Clinically significant muscle weakness induced by oral dantrolene sodium prophylaxis for malignant hyperthermia. Anesthesiology, 65: 312–314.CrossRefGoogle ScholarPubMed