Malignant hyperthermia is a genetic disorder that is associated with the skeletal muscles. The condition arises when a patient is exposed to a dose of anesthetics, which leads to a series of severe reactions. This is because the anesthetics affect the skeletal muscles leading to hypermetabolism, hence the series of severe reactions. This disorder is considered life-threatening. So, to avoid any serious health complications, it is important that an immediate response is given to the patient to alleviate the resultant symptoms. If a malignant hyperthermia reaction is managed early enough, then the patient can fully recover from the condition. However, it is important to remember that in another situation, if the patient is given anesthesia, they will still respond the same. That is provided there is no controlled intervention against the reaction.
What Is The Treatment for Malignant Hyperthermia?
Malignant hyperthermia is treated and managed using Dantrolene as well as supportive care for the patient. As earlier mentioned, if a patient shows any signs of malignant hyperthermia, it is important that an immediate response is given to avoid any further complications. Dantrolene should be administered to the patient without delay and it should continue being given until the patient is stable. That is until the patient shows no symptoms of increased temperatures, muscle rigidity, and hypermetabolic reaction.
In case of any delays in giving the recommended treatment for malignant hyperthermia, the lower the chances of fully recovering from the condition. During surgery, if a patient starts experiencing signs of malignant hyperthermia after being given an anesthesia, the attending anesthesiologist needs to stop the triggering anesthetic.
Dantrolene works by reducing muscle tone and rising metabolic rate and thus stopping the release of calcium from muscle cells. If a patient does not respond to the drug after the first dosage, another dose should be given after five minutes or so until the patient stabilizes. Malignant hyperthermia can also be controlled using ice packs or cooling blankets to help lower the high temperature. Alternatively, cold isotonic saline can also be administered intravenously to cool off the body. These are the two main supportive care procedures often applied during a reactive episode in a patient who is under anesthesia. After the crisis has been managed, the doctors should keep a close eye on the patient for about twenty-four hours until they regain normality and their vital signs are stable.
What Are The Severe Reactions Of Malignant Hyperthermia?
The first thing that happens when a patient susceptible to malignant hyperthermia is given anesthetics, calcium stored in the muscle cells is released. This response is followed by muscle contractions and stiffens which happen concurrently. At the same time, the patient starts experiencing a drastic rise in body temperature (hyperthermia) and increased metabolic rate. A patient may also exhibit symptoms of tachycardia, sweating, tachypnea, and high blood pressure, which then falls sharply.
Due to hyperthermia, body chemistry is affected and potassium, phosphates, and magnesium seep into the extracellular fluid while sodium flows into the cells. In turn, continued increase in potassium levels affect the heart and can cause one to be hypoxic or hypercarbic. On the other hand, continuous muscle contraction leads to rhabdomyolysis, which is the breakdown of muscle fibers. This leads to a leak of potassium and myoglobin into the bloodstream. The latter then causes damage to the renal tubes thus leading to acute renal failure.
Malignant hyperthermia is difficult to diagnose prior to exposure of anesthetics, because a patient exhibits no symptoms then. The predominant symptoms include the release of calcium for skeletal muscles, increased metabolic rate, high temperatures, and muscle stiffness. To manage these symptoms, Dantrolene and other supportive care should be given with urgency for successful management of the condition. After that, Dantrolene needs to be continued, depending on the patient’s response, until they are stable. Other than that, levels of potassium, magnesium, sodium, and phosphates should be monitored as well as renal function, in case the effects of malignant hyperthermia had progressed into dangerous levels.