Emergency under anaesthesia

In malignant hyperthermia skeletal muscle acute-ly and unexpectedly increases its oxygen consumptionand lactate production, and metabolic acidosis. musclerigidity, sympathetic stimulation, and increased cellularpermeability.The best accepted theory is that malignant hyper-thermia is caused by an inability to control calcium con-centrations within the muscle fibre and that it may in-volve a generalized alteration in cellular or subcellularmembrane permeability.Diagnosis is made on the basis of extraordinarytemperature and acid base and muscle aberrations.Specific’ treatment is the action of dantroleneon muscle calcium movements, symptomatic treatment is byreversal of acid base and temperature changes.Evaluation of affected femilies is guided bymeasurements of circulating creatine phosphokinase andby analysis of drug induced contracture is muscle bio-psy specinlens 0Anaesthesia for susceptible patients includethiopental, opiates, DROPeridol, pancuronium, nitrousoxide, and preoperative intravenous doses of dantrolene.