Over the past 50 yr, many drugs have been implicated as triggers of malignant hyperthermia (MH), a potentially fatal pharmacogenetic disorder of skeletal muscle calcium regulation. This review discusses the potent inhalation agents as the principal triggers and evidence that the modern agents, desflurane, sevoflurane, and isoflurane, can cause florid MH reactions in the same way as halothane bu...

T he major reason for monitoring intraoperative temperature is for detection of fever, malignant hyperthermia, and hypothermia. Inadvertent hypothermia-defined by an absolute core temperature <36”C-is by far the most common perioperative thermal disturbance. However, hypothermia may be difficult to evaluate using liquid-crystal thermography, because skin temperatures are l-4°C less than core te...

Malignant hyperthermia is a rare but life-threatening complication of general anesthesia in predisposed patients usually triggered by potent inhalation anesthetics and/or the depolarizing muscle relaxant succinylcholine. The authors present a case of delayed sevoflurane-induced malignant hyperthermia in a 21-year-old male patient that was sufficiently treated by discontinuation of trigger agent...

Hyperthermia is frequently seen in the intensive care setting and is associated with significant morbidity and mortality. It is often initially misdiagnosed as fever associated with infection. Atypical presentations of classic syndromes are common. Clinical suspicion is the key to diagnosis. Adverse drug reactions are a frequent culprit. Syndromes include adrenergic "fever," anticholinergic "fe...

MH produces rapid increase in body temperature (by as much as 1oC in five minutes) and extreme acidosis. These are a result of acute loss of control of intracellular calcium levels and compensatory uncontrolled increases in skeletal muscle metabolism, which may progress to severe rhabdomyolysis. Critical worldwide attention to MH began in 1960 with the reports of Denborough and Lovell. They des...

A malignant hyperthermia (MH) crisis is a medical emergency. To give the patient the best possible chance for a successful outcome, a swift, coordinated, multidisciplinary team response is necessary. Malignant hyperthermia occurs infrequently and, as such, details about its diagnosis, treatment, and management must be reviewed and reinforced during periodic education sessions. An MH response pl...

To the editor: We would like to share recent advancements regarding the utilization of activated charcoal filters to adsorb volatile anesthetic agents (VAAs). Although activated charcoal has been known for many years to adsorb VAAs,1-3 it has only recently become commercially available and endorsed by the Malignant Hyperthermia Association of the United States (MHAUS).4 MHAUS has put forth upda...

Osteogenesis imperfecta is a rare, genetically inherited syndrome involving connective tissue. It results in extremely fragile bones and disorders of other organs and body systems. Children with osteogenesis imperfecta are susceptible to bone fractures and often require surgery and anaesthesia. We describe a series of 14 general anaesthetics in three patients suffering from this disease. In one...

Although neuroleptic malignant syndrome manifests consistently with hyperthermia, muscle rigidity, altered mental status, and autonomic instability, heterogeneity exists in the onset, course, laboratory findings, response to treatment and pattern of resolution. Comorbid physical conditions tend to confuse the picture. We report a case of NMS with one such presentation.Although neuroleptic malig...