Preparations and Drugs, are safe to use in Malignant Hyperthermia-susceptible patients

    

 About 20% of patients redevelop symptoms of Malignant Hyperthermia. The mean time until symptoms redeveloped was 13 hours, with a range of 2.5 to 72 hours. (data from the NAMHR)

     Dantrolene pretreatment is no longer indicated. Dantrolene pretreatment may cause mild weakness in normal patients and significant weakness in patients with muscle disorders.

     The gold standard for diagnosis is the caffeine-halothane contracture test (CHCT). The patient’s muscle is exposed to incremental doses of halothane and caffeine, and the muscle is evaluated for the degree of contracture. Using this test is very limited.


 Preparations for Malignant Hyperthermia-susceptible patients:

  • Clean the anesthetic machine;
  • Remove vaporizers;
  • Replace CO2 absorbent, bellows, and gas hose;
  • Flush the machine for 20 minutes with 10 L/min of oxygen;
  • Schedule the patient for the first case of the day and notify the postanesthesia care unit to be prepared with an appropriate number of personnel;
  • A cooling blanket should be placed under the patient. Refrigerated saline should be available;
  • A nontriggering anesthetic technique such as continuous intravenous infusion of propofol should be used;
  • The patient should be monitored for 6 to 8 hours after surgery;
  • Dantrolene should be available.

read also:
Malignant hyperthermia: Causes and Clinical Manifestations
Emergency Treatment for An Acute Malignant Hyperthermia Crisis

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