J Neurointensive Care.  2024 Oct;7(2):41-48. 10.32587/jnic.2024.00801.

Malignant Hyperthermia: A Life-Threatening Condition in Patients Undergoing Surgical Intervention

• Pal J
• Gupta P
• Maurya VP
• Srivastava AK
• Gupta D
• Moscote-Salazar LR
• Janjua T
• Agrawal A

• KMID: 2563674
• DOI: http://doi.org/10.32587/jnic.2024.00801

Abstract

Malignant hyperthermia (MH) is a rare, potentially fatal genetic disorder characterized by an unexplained elevation of expired carbon dioxide despite increased minute ventilation, muscle rigidity, and rhabdomyolysis, hyperthermia, tachycardia, acidosis, and hyperkalemia. It can be triggered by many pharmacological agents such as potent inhalation agents (halothane/ isoflurane/ sevoflurane/ desflurane), the depolarizing muscle relaxant (succinylcholine), and extreme physiological conditions such as vigorous exercise and working excessively in a hot and dry environment. Prompt and early recognition of the condition and rapid initiation of treatment measures are necessary to salvage the patient. Since MH is commonly encountered in the operating room or early postoperative period, anesthetists and surgeons need to keep themselves updated regarding the same. This review article aims to summarize our understanding of MH's pathophysiology, current diagnostics, management, and treatment strategies, along with a brief review of literature of published cases in Indian Subcontinent.

Keyword

Malignant hyperthermia; Dantrolene; Inhalational anesthesia; Hyperthermia; Tachycardia