malignant hyperthermia in dental and facial plastic surgeries
Clicks: 177
ID: 256037
2015
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This
article has not been analysed, so there is no overall score —
reader engagement is measured and shown alongside.
Reader Engagement
Popular Article
30.0
/100
177 views
33 readers
AI Quality Assessment
Not analyzed
Readership in this journal
PopularRanked #43 of 61 articles by views in Asian journal of psychiatry
Most read
Least read
Bar heights use a square-root scale.
Mint this article as an NFT
Not yet mintedCreate a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.
5
SUSD
one-off · no wallet required
Abstract
Preoperative evaluation of the patients scheduled for ambulatory surgery is of great importance in regards of both surgery and anesthesia considerations. Malignant Hyperthermia (MH) is a pharmacogenetic clinical syndrome which mostly arises from volatile anesthesia with halothane and the depolarizing muscle relaxant succinylcholine. Clinical manifestations of MH are acidosis and rhabdomyolysis which occur following uncontrolled increases in skeletal muscle metabolism and rapidly increasing body temperature (by as much as 1°C/5 min) (1). Primary cases of MH were reported to be of a 70% mortality rate; however, thanks to the emergence of diagnostic tools such as end-expired carbon dioxide and the administration of dantrolene, this rate has decreased to less than 5%.
MH might occur even in those with no previous or familial history. Even a safe history of the previous surgery under the administration of MH triggering agents cannot guarantee a next safe surgery. A noteworthy point in the preoperative evaluation is the probable association of MH with certain musculoskeletal disorders including Duchenne, Becker, and myotonic muscular dystrophies, strabismus, osteogenesis imperfecta, ptosis, myelomeningocele, kyphoscoliosis, King-Denborough syndrome, periodic paralysis, hernias, marfanoid syndrome, and central core disease (1). These diseases are frequently encountered by dental and facial plastic surgeons and having the knowledge of the probable association between MH and these conditions could aware the dental and facial plastic surgeons and the anesthesiologists to be more vigilant.
Although MH workup leads to the definite diagnosis, no convincing intraoperative diagnostic tool has been introduced so far. Masseter spasm is a condition which might follow administration of depolarizing neuromuscular blocking agents due to the slow tonic fibers of masseter and lateral pterygoid muscles (2-4). The severer forms of masseter spasm would result in masseter tetany or “jaws of steel” preventing any mouth opening. In cases with exclusively jaws of steel or those with Masseter spasm in combination with the rigidity of other body muscles, the occurrence of MH is almost definite and the surgical procedure should be terminated. Nevertheless, if either the jaw is only slightly resistant to opening or the rigidity of other muscles does not accompany the Masseter spasm, anesthesia might continue with non-triggering agents under proper monitoring including end-tidal CO2, pigmenturia evaluation, and arterial or venous blood sampling for creatine kinase, acid-base status, and electrolyte levels, mainly potassium.
Considering the fact that anesthesiologists do not have access to the head and neck of the patients throughout dental and facial plastic surgeries, the vigilance and awareness of the surgeons in detecting masseter spasms in patients would immensely help with the early diagnosis of MH and save the lives of susceptible patients.
| Reference Key |
maheri2015advancesmalignant
Use this key to autocite in the manuscript while using
SciMatic Manuscript Manager or Thesis Manager
|
|---|---|
| Authors | ;Ramin Maheri;Samad EJ Golzari;Reza Rikhtegar |
| Journal | Asian journal of psychiatry |
| Year | 2015 |
| DOI |
DOI not found
|
| URL | |
| Keywords |
Citations
No citations found. To add a citation, contact the admin at info@scimatic.org
Comments
No comments yet. Be the first to comment on this article.