Abstract
BackgroundWhile the impact of volatile anaesthetics to induce malignant hyperthermia (MH) is abundantly clear, the role of succinylcholine still remains controversial. To evaluate the influence of succinylcholine on porcine MH events, the authors investigated the hemodynamic and metabolic responses in MH susceptible (MHS) and non-susceptible (MHN) swine following either succinylcholine or halothane application alone or a combination of both substances.MethodsWith approval of the local animal care committee 27 MHS and 30 MHN pigs were anaesthetized and mechanically ventilated. Fiberoptic probes for continuous PCO2 measurement were inserted into the femoral vein and the triceps muscle. Group A received succinylcholine 4 mg/kg, group B incremental doses of halothane (0.5, 1.0 vol%) and group C succinylcholine and halothane simultaneously. Vital signs were recorded continuously.ResultsPrior to drug application measured values did not differ between MHS and MHN. While MHN pigs did not show relevant alterations, succinylcholine, halothane and the combination of both lead to significant hemodynamic and metabolic changes in MHS swine.ConclusionsHemodynamic and metabolic alterations following succinylcholine were similar to halothane in MHS pigs. The combination of both pharmacological agents potentiated the observed effects. According to these results succinylcholine acted as an independent and supportive factor during onset of an MH episode.
Highlights
While the impact of volatile anaesthetics to induce malignant hyperthermia (MH) is abundantly clear, the role of succinylcholine still remains controversial
Clinical occurrence of MH According to the predefined metabolic parameters none of the Malignant hyperthermia non-susceptible (MHN) swine developed any clinical signs of an MH episode after application of SCh, halothane or both agents
MH occurred in all MH susceptible (MHS) animals of the halothane and the SCh plus halothane group, while only four out of nine MHS pigs in the SCh group fulfilled the defined criteria
Summary
While the impact of volatile anaesthetics to induce malignant hyperthermia (MH) is abundantly clear, the role of succinylcholine still remains controversial. Malignant hyperthermia (MH) is a potentially lethal pharmacogenetic disorder characterized by a disturbance of skeletal muscle calcium homeostasis. While the impact of volatile anaesthetics in the development of MH is abundantly clear, the role of the depolarising muscle relaxant succinylcholine (SCh) still remains controversial [2]. Application of commonly used halogenated anaesthetics induces pathological muscular contractions in muscle bundles of susceptible patients in vitro [3], whereas SCh did not induce a reproducible muscular response [4]. Reliable reports of fulminant MH episodes in humans or animals induced by administration of SCh alone are lacking in the current literature [2]
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