Outpatient Surgery Magazine

Marking Madness - April 2013 - Subscribe

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 112 of 157

OSM560-April_DIGITAL_Layout 1 4/5/13 2:31 PM Page 113 to this sudden surgical complication? Read on to learn from 2 emergency situations that the hotline experts from the Malignant Hyperthermia Association of the United States have consulted on. Case 1: Fatal Result CAUSE FOR CAUTION MH-Triggering Agents Inhaled General Anesthetics: Desflurane Enflurane Ether Halothane Isoflurane Methoxyflurane Sevoflurane Depolarizing Muscle Relaxant: Succinylcholine An athletic teen presented for elective ankle surgery. Sevoflurane, which is known to trigger MH, was administered, but not the neuromuscular blocker succinylcholine, also known as a triggering agent. Soon after induction, the signs of MH began to appear, including increased end-tidal CO2, increased heart rate and muscle rigidity in all extremities. In addi- tion, serum potassium was elevated and acidosis was present. The anesthesiologist and OR staff moved quickly. Once they made the diagnosis, they secured dantrolene and administered it at the recommended dose of 2.5mg/kg. They called the MH hotline, turned off the anesthetic gas and sent laboratory studies. Usually these steps would immediately reverse the signs, but not in this case. In some cases, additional READY TO RESPOND An MH cart or kit containing an emergency response plan, dantrolene, sterile water, syringes and other essentials is a must-have wherever general anesthesia is administered. A P R I L 2 013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E | 1 1 3

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