Solve doubts! “Malignant hyperthermia”

Health News

25 Jul 2023

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Solve doubts! “Malignant hyperthermia”

Many people may have seen news about deaths related to receiving anesthesia, which can create fear and apprehension about undergoing surgery or receiving anesthesia. However, in reality, the main causes are often a lack of physical examination and assessment of the patient's readiness, as well as other factors such as excessive bleeding or severe underlying medical conditions. It is important to inform the surgeon of the following before undergoing surgery:

Things to inform the doctor before surgery:

History of allergic reactions to anesthesia or if anyone in the family has had an allergic reaction to anesthesia. Also, mention any past experiences with anesthesia.
Undergo a physical examination and provide the doctor with a medical certificate. The physical examination will assess the risk.
History of illness, ongoing illness, or current medication use.
Pregnancy status.
If the patient is over 35 years old, it is recommended to have an electrocardiogram (ECG) to check the heart's strength and rhythm.
Smoking or alcohol consumption habits, and the frequency of use.

Symptoms of an allergic reaction to anesthesia:

Within a few hours of receiving anesthesia, the following abnormal symptoms may occur:

Continuous muscle stiffness without relaxation.
Higher than normal fever.
Excessive sweating.
Rapid and wheezing breathing.
Irregular heartbeat and pulse.
Skin turning dark green.
Reduced urine output with dark brown color.
Slow blood circulation or blood loss from the body.
Low blood pressure.
Fatality.

Injection or Inhalation Anesthesia: Which Technique is Better?

If discussing "inhalation anesthesia," the patient will not be conscious during the surgery and will not be aware of the surgical events, such as the incision or the surgeon interacting with the body. The patient will not feel pain and is suitable for major surgeries that require a long duration and significant blood loss. On the other hand, "injection anesthesia" is administered to specific points and areas where the surgery will take place. This technique is suitable for minor surgeries such as eye, nose, and mouth surgeries. It provides numbness in a specific location without affecting consciousness. The patient remains awake during the procedure and does not feel pain. The choice between injection anesthesia and inhalation anesthesia depends on the specific surgery, and the decision should be made based on the doctor's recommendation.

Malignant hyperthermia are very rare. Worldwide reports indicate a rate of 1 in 100,000 adults and 1 in 30,000 children. In Thailand, the reported rate is approximately 1 in 200,000 or 0.0005%. The cause is often attributed to genetic mutations that can be inherited as a dominant gene from parents to offspring. It is more commonly found in males than females. If anyone in the family has a history of malignant hyperthermia or any abnormalities during surgery, it is important to inform the healthcare provider before any procedure.