Abstract
The effects on erythrocyte fragility of two general anaesthetic agents (halothane and ethanol) and succinylcholine were examined using preparations from 13 normal and four malignant hyperthermia susceptible patients. Erythrocyte fragility was determined by the degree of haemolysis induced in solutions of decreasing osmolarity of NaCl. Halothane caused haemolysis of erythrocytes in an isoosmolar solution, being more potent at 42° C than at 32° C. Haemolysis produced by an hypoosmolar medium or halothane was potentiated by exogenously added phospholipase A2. Ethanol did not markedly alter the haemolysis of erythrocytes under conditions of decreasing osmolarity. Succinylcholine 10 mM did not significantly alter the susceptibility of erythrocytes to lysis by halothane. No differences in erythrocyte fragility were observed between preparations from normal and malignant hyperthermia susceptible patients under any of the conditions tested, despite the inclusion of malignant hyperthermia triggering agents in some instances. Although sampling a larger patient population might reveal slight differences between the groups, erythrocyte fragility tests do not appear to be useful in differentiating malignant hyperthermia susceptible from normal patients.
Résumé
Les effets de la fragilité érythrocytaire produite par deux agents anesthésiques généraux (ľhalothane et ľêthanol) et par la succinylcholine ont été examinés à ľaide de préparations provenant de treize patients normaux et de quatre patients susceptibles à ľhypertkermie maligne. La fragilité érythrocytaire a été déterminée par le degré ďhémolyse induit par des solutions ďosmolarité décroissante de NaCl. ľhalothane a causé une hémolyse des érythrocytes dans une solution isoosmolaire, qui était plus puissante à 42° Cqu’à32° C. Ľhémolyse produite par un milieu hypoosmolaire ou par ľhalothane a été potentialisée par ľajout exogène de phospholipase A2. ľêthanol n’a pas modifié de façon marquée ľhémolyse des érythrocytes dans des conditions ďosmolarité décroissante. La susceptibilité de lyse des érythrocytes causée par ľhalothane n’a pas été modifiée de façon significative par les 10 mM de succinylcholine. On a remarqué aucune différence dans la fragilité érythrocytaire entre les préparations provenant des patients normaux et celles provenant de patients susceptibles à ľhypertkermie maligne, dans aucune des épreuves vérifiées, malgré ľinclusion ďagents déclencheurs ďhyperthermic maligne dans certains cas. Quoique ľéchantillonnage ďune population plus grande de patients pourrait révéler des différences légères entre les groupes, les tests de fragilité érythrocytaire ne semblent pas être utiles pour différencier les patients normaux des patients susceptibles à ľhyperthermic maligne.
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Tolpin, E.I., Fletcher, J.E., Rosenberg, H. et al. Effects of anaesthetic agents on erythrocyte fragility: comparison of normal and malignant hyperthermia susceptible patients. Can J Anaesth 34, 366–372 (1987). https://doi.org/10.1007/BF03010135
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DOI: https://doi.org/10.1007/BF03010135