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Malignant Hyperthermia

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Consults in Obstetric Anesthesiology

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Abstract

Malignant hyperthermia is a hypermetabolic crisis of unregulated calcium accumulation and muscle activation in response to halogenated volatile anesthetics and succinylcholine. It is most frequently caused by mutations in the ryanodine receptor, a calcium channel in the sarcoplasmic reticulum of myocytes. Symptoms include masseter muscle spasm, generalized muscle rigidity, hypercarbia, a mixed metabolic and respiratory acidosis, hyperthermia, hyperkalemia, rhabdomyolysis, myoglobinuria, arrhythmias, and cardiovascular collapse. Management consists of dantrolene, supportive care, and avoidance of triggers. The gold standard test is the caffeine halothane contracture test. Genetic testing is possible, but not all mutations are known. Parturients who are susceptible to MH or whose fetuses may be susceptible to MH should receive regional anesthesia or non-triggering anesthetics if general anesthesia is required.

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Authors and Affiliations

  1. California Pacific Medical Center, San Francisco, CA, USA

    Julia R. Menshenina M.D.

  2. Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA

    Suzanne K. W. Mankowitz M.D. (Associate Professor)

Authors
  1. Julia R. Menshenina M.D.
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  2. Suzanne K. W. Mankowitz M.D.
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Correspondence to Suzanne K. W. Mankowitz M.D. .

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Editors and Affiliations

  1. Associate Professor, Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA

    Suzanne K. W. Mankowitz

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Menshenina, J.R., Mankowitz, S.K.W. (2018). Malignant Hyperthermia. In: Mankowitz, S. (eds) Consults in Obstetric Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-59680-8_100

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  • DOI: https://doi.org/10.1007/978-3-319-59680-8_100

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59679-2

  • Online ISBN: 978-3-319-59680-8

  • eBook Packages: MedicineMedicine (R0)

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