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Follow-up of patients tested for malignant hyperthermia susceptibility

Published online by Cambridge University Press:  19 June 2006

D. Scala ,
A. Di Martino ,
S. Cozzolino ,
A. Mancini ,
A. Bracco ,
B. Andria ,
A. Tammaro  and
G. Savoia
D. Scala
Affiliation:
Cardarelli Hospital, Biotechnology Centre, Naples, Italy
A. Di Martino
Affiliation:
Cardarelli Hospital, Biotechnology Centre, Naples, Italy
S. Cozzolino
Affiliation:
Cardarelli Hospital, Biotechnology Centre, Naples, Italy
A. Mancini
Affiliation:
Cardarelli Hospital, Biotechnology Centre, Naples, Italy
A. Bracco
Affiliation:
Cardarelli Hospital, Biotechnology Centre, Naples, Italy
B. Andria
Affiliation:
Cardarelli Hospital, Biotechnology Centre, Naples, Italy
A. Tammaro
Affiliation:
Cardarelli Hospital, Biotechnology Centre, Naples, Italy
G. Savoia
Affiliation:
Cardarelli Hospital, Anestesia e Rianimazione del Dipartimento Materno Infantile, Naples, Italy
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Abstract

Summary

Background and objective: Malignant hyperthermia is an inherited disorder of skeletal muscle characterized by muscle contracture and hypermetabolic crisis following exposure to halogenated anaesthetics and depolarizing muscle relaxants. We planned this follow-up to get more information about the safety of non-triggering anaesthesia in susceptible patients; the safety of the use of trigger agents in non-susceptible patients and any minor sequelae following the biopsy. Methods: A questionnaire was sent to 244 patients tested for susceptibility between 1998 and 2004 enquiring about sequelae from the biopsy, subsequent experience with anaesthesia and difficulties encountered because of the investigation. Results: Replies were received from 129 patients. Thirty-four complained about sequelae from the biopsy: 10 reported headache and nausea; 16 experienced pain and a lack of strength in the biopsed leg and 8 found the scar less than satisfactory. Ten patients found it difficult to find a diagnostic centre. Eighteen reported problems and/or delay when they had needed a subsequent anaesthetic. Fourteen patients found the anaesthesiologist reluctant to anaesthetize them and four experienced a delay. Forty-three patients received anaesthesia since their biopsy. Complete medical records were available for 24 anaesthetic exposures in 23 patients. No documented perioperative complications occurred. Only three non-susceptible patients received one trigger agent. Conclusions: It is safe to use trigger-free anaesthesia in susceptible patients. The difficulties encountered by patients to be anaesthetized and the management of the majority of non-susceptible patients during general anaesthesia show the need of more accurate educational programmes and methods for promoting patient-centred care.

Keywords

MALIGNANT HYPERTHERMIA, complicationsANAESTHESIA, general, regional, inhalationalEDUCATION
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 9 , September 2006 , pp. 801 - 805
Copyright
2006 European Society of Anaesthesiology

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