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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.
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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.

Information

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

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