MALIGNANT

HYPERTHERMIA
 Definition

• lethal genetic
disorder of muscle
hypermetabolism
triggered by
exposure to volatile
anesthetic agents
and succinylcholine.
Pathogenesis
Dantrolene sodium is a postsynaptic muscle relaxant
that lessens excitation-contraction coupling in muscle
cells. It achieves this by inhibiting Ca2+ ions release
from sarcoplasmic reticulum stores by antagonizing
ryanodine receptors.
Anesthetic management
• Identification (central core
• disease, King-Denborough syndrome, and Evans myopathy)
• Dantrolene prophylaxis is not indicated or recommended.
• Children should be given a liberal dose of oral anxiolytic(s)
preoperatively (midazolam ± oral ketamine).
• If the patient does not show clinical signs of MH within the first hour
after a nontriggering anesthetic, MH is unlikely to occur later.
• All patients must be monitored for at least 1 hour (preferably 4 hours)
in the postoperative period.
Anesthetic management
• an MH-dedicated anesthesia machine that was never exposed to
volatile anesthetics should be used.
• Otherwise the anesthesia station must be flushed with high-flow
oxygen for the recommended length of time (from 20 minutes to
>100 minutes) specific to each model.
Thank You