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Contractures in skeletal muscle of malignant hyperthermia susceptible patients after in vitro exposure to sevoflurane.
Acta Anaesthesiol Scand. 2000 Mar; 44(3):334-7.AA

Abstract

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+Show Affiliations

Department of Anaesthesiology, University Hospital Nijmegen, The Netherlands. Anesthesie@cwz.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10714850

Citation

Snoeck, M M., et al. "Contractures in Skeletal Muscle of Malignant Hyperthermia Susceptible Patients After in Vitro Exposure to Sevoflurane." Acta Anaesthesiologica Scandinavica, vol. 44, no. 3, 2000, pp. 334-7.
Snoeck MM, Gielen MJ, Tangerman A, et al. Contractures in skeletal muscle of malignant hyperthermia susceptible patients after in vitro exposure to sevoflurane. Acta Anaesthesiol Scand. 2000;44(3):334-7.
Snoeck, M. M., Gielen, M. J., Tangerman, A., van Egmond, J., & Dirksen, R. (2000). Contractures in skeletal muscle of malignant hyperthermia susceptible patients after in vitro exposure to sevoflurane. Acta Anaesthesiologica Scandinavica, 44(3), 334-7.
Snoeck MM, et al. Contractures in Skeletal Muscle of Malignant Hyperthermia Susceptible Patients After in Vitro Exposure to Sevoflurane. Acta Anaesthesiol Scand. 2000;44(3):334-7. PubMed PMID: 10714850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contractures in skeletal muscle of malignant hyperthermia susceptible patients after in vitro exposure to sevoflurane. AU - Snoeck,M M, AU - Gielen,M J, AU - Tangerman,A, AU - van Egmond,J, AU - Dirksen,R, PY - 2000/3/14/pubmed PY - 2000/3/25/medline PY - 2000/3/14/entrez SP - 334 EP - 7 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 44 IS - 3 N2 - 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. SN - 0001-5172 UR - https://www.unboundmedicine.com/medline/citation/10714850/Contractures_in_skeletal_muscle_of_malignant_hyperthermia_susceptible_patients_after_in_vitro_exposure_to_sevoflurane_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0001-5172&date=2000&volume=44&issue=3&spage=334 DB - PRIME DP - Unbound Medicine ER -