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[In-vitro-effects of cocaine in skeletal muscle specimens of patients susceptible to malignant hyperthermia].

Abstract

OBJECTIVE

The abuse of cocaine can cause serious medical complications like tachycardia, rhabdomyolysis, and hyperthermia. Because of the clinical similarities, it has been suggested that cocaine might be a trigger of malignant hyperthermia (MH). Therefore, aim of this study was to investigate the in-vitro effects of cocaine in skeletal muscle specimens of MH susceptible (MHS) and normal (MHN) patients.

METHODS

62 patients undergoing the in-vitro contracture test (IVCT) according to the protocol of the European MH Group (EMHG) for diagnosis of MH susceptibility were included in this study. In muscle specimens surplus to diagnostic requirements cocaine was added in order to achieve tissue bath concentrations of 0.01, 0.1 and 1.0 mM. The contracture development and twitch response have been registered.

RESULTS

21 patients were diagnosed as MHS and 36 patients as MHN. 5 patients tested as MH-equivocal (MHE) were excluded from the study. Following bolus administration of cocaine, no contracture development was observed in MHS, as well as MHN specimens. The muscle twitch decreased after cocaine administration significantly in both diagnostic groups.

CONCLUSION

In contrast to the established MH trigger substances like volatile anaesthetics, cocaine produced no contracture development in MHS muscle specimens. Furthermore, cocaine produced a negative inotropic effect in all skeletal muscle preparations, which might be explained by local anaesthetic effects. Regarding these results, cocaine seems not to be a MH trigger agent.

Authors+Show Affiliations

Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf. weisshorn@uke.uni-hamburg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

11889614

Citation

Weisshorn, R, et al. "[In-vitro-effects of Cocaine in Skeletal Muscle Specimens of Patients Susceptible to Malignant Hyperthermia]." Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS, vol. 37, no. 3, 2002, pp. 138-43.
Weisshorn R, Wappler F, Fiege M, et al. [In-vitro-effects of cocaine in skeletal muscle specimens of patients susceptible to malignant hyperthermia]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2002;37(3):138-43.
Weisshorn, R., Wappler, F., Fiege, M., Gerbershagen, M., & Schulte Am Esch, J. (2002). [In-vitro-effects of cocaine in skeletal muscle specimens of patients susceptible to malignant hyperthermia]. Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS, 37(3), 138-43.
Weisshorn R, et al. [In-vitro-effects of Cocaine in Skeletal Muscle Specimens of Patients Susceptible to Malignant Hyperthermia]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2002;37(3):138-43. PubMed PMID: 11889614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [In-vitro-effects of cocaine in skeletal muscle specimens of patients susceptible to malignant hyperthermia]. AU - Weisshorn,R, AU - Wappler,F, AU - Fiege,M, AU - Gerbershagen,M, AU - Schulte Am Esch,J, PY - 2002/3/13/pubmed PY - 2002/5/30/medline PY - 2002/3/13/entrez SP - 138 EP - 43 JF - Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS JO - Anasthesiol Intensivmed Notfallmed Schmerzther VL - 37 IS - 3 N2 - OBJECTIVE: The abuse of cocaine can cause serious medical complications like tachycardia, rhabdomyolysis, and hyperthermia. Because of the clinical similarities, it has been suggested that cocaine might be a trigger of malignant hyperthermia (MH). Therefore, aim of this study was to investigate the in-vitro effects of cocaine in skeletal muscle specimens of MH susceptible (MHS) and normal (MHN) patients. METHODS: 62 patients undergoing the in-vitro contracture test (IVCT) according to the protocol of the European MH Group (EMHG) for diagnosis of MH susceptibility were included in this study. In muscle specimens surplus to diagnostic requirements cocaine was added in order to achieve tissue bath concentrations of 0.01, 0.1 and 1.0 mM. The contracture development and twitch response have been registered. RESULTS: 21 patients were diagnosed as MHS and 36 patients as MHN. 5 patients tested as MH-equivocal (MHE) were excluded from the study. Following bolus administration of cocaine, no contracture development was observed in MHS, as well as MHN specimens. The muscle twitch decreased after cocaine administration significantly in both diagnostic groups. CONCLUSION: In contrast to the established MH trigger substances like volatile anaesthetics, cocaine produced no contracture development in MHS muscle specimens. Furthermore, cocaine produced a negative inotropic effect in all skeletal muscle preparations, which might be explained by local anaesthetic effects. Regarding these results, cocaine seems not to be a MH trigger agent. SN - 0939-2661 UR - https://www.unboundmedicine.com/medline/citation/11889614/[In_vitro_effects_of_cocaine_in_skeletal_muscle_specimens_of_patients_susceptible_to_malignant_hyperthermia]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2002-21806 DB - PRIME DP - Unbound Medicine ER -