December 2006, Volume 36 Number 12 , p 26 - 27
DIXON, BETTINA A. CRNA, MSN; O'DONNELL, JOHN M. CRNA, MSN
MALIGNANT HYPERTHERMIA (MH) is an inherited and potentially fatal syndrome that some patients develop when they receive anesthetic drugs such as isoflurane, halothane, sevoflurane, desflurane, or the skeletal muscle relaxant succinylcholine. In these patients, the drugs trigger uncontrolled calcium release within skeletal muscle cells, causing muscle rigidity and an acute hypermetabolic state. Signs and symptoms of MH include jaw muscle rigidity, rapidly increasing temperature, elevated Paco 2 and serum potassium levels, metabolic acidosis, tachycardia, tachypnea, and hypertension. Eventual muscle cell breakdown (rhabdomyolysis) can lead to kidney failure.
At one time, 70% to 80% of patients with acute MH died, but mortality has dropped to less than 5% since the muscle relaxant dantrolene (Dantrium) was introduced in 1979. Dantrolene helps attenuate an MH crisis by decreasing calcium release from ...