Document Detail


Contractures in skeletal muscle of malignant hyperthermia susceptible patients after in vitro exposure to sevoflurane.
MedLine Citation:
PMID:  10714850     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sevoflurane, a potent inhalational anaesthetic agent that is structurally similar to halothane, has some favourable characteristics, but may also be able to trigger malignant hyperthermia (MH) in susceptible patients. The diagnosis of malignant hyperthermia susceptibility relies on the in vitro contracture test on skeletal muscle. The present study was undertaken to investigate whether exposure to sevoflurane of muscles of malignant hyperthermia susceptible (MHS) patients would also cause an abnormal contracture. METHODS: Muscle fascicles obtained from three MHS patients, one malignant hyperthermia non-susceptible (MHN) patient, two control patients and one malignant hyperthermia equivocal (MHE) patient were exposed to sevoflurane instead of halothane in the in vitro contracture test, carried out according to the protocol of the European Malignant Hyperthermia Group. The muscle fascicles were surplus to diagnostic requirements. Sevoflurane concentrations in the testbath were measured using a headspace gas chromatographic technique. RESULTS: The kinetics of sevoflurane concentration in the testbath were similar to those of halothane. An in vitro contracture response of 2 mN or more was seen in all four MHS/MHE patients with sevoflurane but not in the three control/MHN patients. The magnitude of muscle contracture in the sevoflurane test was less than in the conventional halothane test at comparable testbath concentrations. CONCLUSIONS: Sevoflurane can trigger an abnormal contracture in human muscle in vitro. This is indicative of malignant hyperthermia susceptibility. Exposure to sevoflurane should be avoided in patients thought to be susceptible to malignant hyperthermia.
Authors:
M M Snoeck; M J Gielen; A Tangerman; J van Egmond; R Dirksen
Publication Detail:
Type:  In Vitro; Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  44     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-03-23     Completed Date:  2000-03-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  334-7     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, University Hospital Nijmegen, The Netherlands. Anesthesie@cwz.nl
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Inhalation / adverse effects*
Caffeine / pharmacology
Humans
Malignant Hyperthermia / etiology*
Methyl Ethers / adverse effects*
Muscle Contraction / drug effects*
Muscle, Skeletal / drug effects*,  physiology
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane; 58-08-2/Caffeine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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