Malignant hyperthermia and its implications in general dentistry

Gen Dent. 2009 May-Jun;57(3):242-6; quiz 247-8.

Abstract

Malignant hyperthermia (MH) is an uncommon and potentially life-threatening pharmacogenetic disorder. This abnormality in muscle metabolism can be triggered by a variety of agents (particularly general anesthetics and stress), resulting in a rapid heart rate increase, muscle rigidity, acidosis, temperature elevation, rhabdomyolysis, and renal failure. Immediate discontinuing of triggering agents, oxygenation, cooling, and dantrolene are necessary to treat an episode. MH-susceptible patients often indicate a positive family history of experiencing an adverse event during anesthesia. Few diagnostic tests are available to screen patients; the most accurate test is a skeletal muscle biopsy. MH-susceptible patients can undergo surgical procedures as necessary. Careful exploration of the medical history will allow the clinician to make the necessary modifications to treat and manage an episode expediently.

Publication types

  • Review

MeSH terms

  • Anesthesia, Dental / adverse effects*
  • Anesthesia, General / adverse effects*
  • Dental Care for Chronically Ill*
  • General Practice, Dental
  • Humans
  • Malignant Hyperthermia* / etiology
  • Malignant Hyperthermia* / physiopathology
  • Neuromuscular Depolarizing Agents / pharmacology
  • Ryanodine Receptor Calcium Release Channel / genetics

Substances

  • Neuromuscular Depolarizing Agents
  • Ryanodine Receptor Calcium Release Channel