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Query: UMLS:C0024591 (malignant hyperthermia)
 2,353 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical uses of calcium channel blockers are expanding. In addition to the established uses in patients with arrhythmias, angina pectoris or hypertension, newer and to some extent investigational uses indicate widespread application. For instance, their use has been reported in hypertrophic cardiomyopathy and cold cardioplegia, as well as in pulmonary hypertension, antiplatelet therapy, asthma, achalasia and oesophageal spasm, increased intraocular pressure and in cerebral vasospasm. Their use in obstetrical practice has been proposed. Thus, the presentation of a patient who is treated with calcium channel blockers and who requires anaesthesia will become more common. Calcium channel blockers may, under certain circumstances, potentiate haemodynamic and MAC depressive effects of inhalation agents. There is also evidence that the effects of neuromuscular blocking agents may be potentiated. The anaesthetist should be aware that the potential for interactions exists with digoxin, propranolol, quinidine, theophylline or dantrolene. Of interest and some significance are the anaesthetic implications of pathophysiological alterations that can be induced by calcium channel blockers, by affecting lower oesophageal tone, intracranial hypertension, bronchomotor tone (asthma), muscular dystrophy, neuromuscular function, hypoxic pulmonary vasoconstriction, malignant hyperthermia, inhibition of platelet aggregation and hyperkalemia. Despite these significant potential anaesthetic implications and because, at this time, in some instances withdrawal has clearly demonstrated increase in the signs of myocardial ischaemia, it would not seem necessary to recommend preoperative discontinuation of calcium channel blocker medication in patients presenting for anaesthesia. It is, however, appropriate that there is a high index of awareness of potential problems, unless there is some modification in inhalation anaesthetic concentrations and neuromuscular blocker dosage. Monitoring of cardiovascular and neuromuscular functions is essential. Calcium channel blockers would appear to be currently the drugs of choice for angina pectoris, arrhythmias or hypertension in patients with associated chronic obstructive pulmonary disease.
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PMID:Anaesthetic implications of calcium channel blockers. 286 80

A 17-year-old male received general anesthesia for repair of a torn right knee anterior cruciate ligament. The medical history revealed manic-depressive psychosis, treated with lithium carbonate and sertraline hydrochloride, and asthma for which the patient occasionally used an albuterol inhaler. Induction with propofol, isoflurane, nitrous oxide, and oxygen was uneventful. Anesthesia was maintained by isoflurane, nitrous oxide, and oxygen. During the first 90 minutes after induction, a persistent mild elevation in end-tidal carbon dioxide was noted, and several possible causes for this elevation were subsequently ruled out. A diagnosis of malignant hyperthermia was made when the patient exhibited tachycardia and a temperature increase, although some discussion remained regarding the possibility of neuroleptic malignant syndrome. The patient was treated successfully using a malignant hyperthermia protocol. Malignant hyperthermia may prove fatal if effective treatment is delayed. Favorable outcome and patient prognosis rely on astute vigilance, accurate diagnosis, and swift, appropriate treatment.
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PMID:Differential diagnosis of malignant hyperthermia: a case report. 892 98

Seventy-four responses were received from a questionnaire which had been mailed to 91 bone marrow transplantation institutes throughout Japan to assess the activity of bone marrow transplantation and complications in bone marrow donors. A total of 2329 bone marrow harvests, performed from 1688 adult donors and 641 child donors for allogeneic or syngeneic transplantation up to August 1992, were available for study. Analyses of the responses showed slight diversity regarding the marrow harvesting preparation and methods of the different bone marrow programs. The resulting perioperative complications were principally caused by anesthesia: 73 episodes of hypotension including one death 18 months later, seven of arrhythmia, one of respiratory arrest, three of mental confusion, one of asthma, one of malignant hyperthermia, one tooth injury and one broken aspiration needle. The postoperative complications were chiefly caused by marrow aspiration per se: 731 episodes of transient fever, 26 of long-lasting pain or discomfort, 10 episodes of liver dysfunction including two cases of non-A, non-B hepatitis, four cases of infection, one episode of hypotension, one of dysuria and one case of keloid formation. The study further revealed that the frequency of complications was lower in child donors than in adult donors.
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PMID:[Complications of marrow harvesting for transplantation]. 813 99

Acute asthma is well known to provoke complications. We report the case of a patient who needed intubation and mechanical ventilation for acute asthma. Despite a treatment with corticosteroids, bronchodilators, neuromuscular blocking drugs and magnesium sulfate, the situation remained uncontrolled and as a last resort, halothane became necessary. The patient then developed an episode of malignant hyperthermia with fever at 40 degrees C and rhabdomyolysis. At this time, halothane could be stopped and all the symptoms disappeared without modifying the rest of the treatment. Eight days later, he presented with a neuroleptic malignant syndrome following an injection of droperidol. Temperature rose to 42 degrees C, associated with muscle rigidity, sweating, tachycardia and severe circulatory collapse. The use of dantrolene in association with a symptomatic treatment of the collapse led to a favourable outcome in. Unfortunately, in vitro contracture test could not be performed in this case. The links between malignant hyperthermia and neuroleptic malignant syndrome remain unclear. Although these two pathologies share the same physiopathology, symptomatology and treatment, they are clearly individualized. This case seems to be the first description of their occurrence in the same patient.
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PMID:Malignant hyperthermia and neuroleptic malignant syndrome in a patient during treatment for acute asthma. 992

We report a case of fulminant-malignant hyperthermia that occurred after five uneventful sevoflurane anesthetic procedures. A 7-year-old girl with bronchial asthma was scheduled for closure of palatal fistula under general anesthesia, after five previous uneventful operations under sevoflurane anesthesia. Anesthesia was induced with propofol and vecuronium, and maintained with nitrous oxide, oxygen, and sevoflurane. Body temperature at the beginning of operation was 37.0 degrees C. After 5 hr 10 min, sudden tachycardia and elevations in body temperature and PET(CO2) were noticed. Sevoflurane was discontinued and body surface cooling, hyperventilation with 100% oxygen, and administration of dantrolene sodium 2 mg x kg(-1), furosemide 4 mg, and 7% NaHCO3 solution 10 ml were started on a suspicion of malignant hyperthermia. Body temperature, heart rate, and PET(CO2) reached to 40.1 degrees C, 190 beats x min(-1), and 60 mmHg, respectively, with metabolic acidosis. Twenty minutes after starting dantrolene infusion, these values decreased to 38 degrees C, 150 beats x min(-1), and 39 mmHg, respectively. Laboratory examination showed that serum potassium, CK, AST, ALT, and LDH concentrations and urine myoglobin level were within normal ranges. Clinical symptoms of this patient fulfilled the diagnostic criteria of fulminant-malignant hyperthermia. The trigger drug was considered to be sevoflurane despite the five previous uneventful sevoflurane anesthetic procedures.
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PMID:[Case of fulminant-malignant hyperthermia occurring on sixth sevoflurane anesthesia]. 2171 Jul 67