@article{SchusterJohannsenMoegeleetal.2014,
  author    = {Schuster, Frank and Johannsen, Stephan and Moegele, Susanne and Metterlein, Thomas and Roewer, Norbert and Anetseder, Martin},
  title     = {The effect of succinylcholine on malignant hyperthermia events in susceptible swine},
  doi       = {10.1186/1471-2253-14-14},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-110302},
  year      = {2014},
  abstract  = {Background While 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. Methods With 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. Results Prior 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. Conclusions Hemodynamic 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.},
  language  = {en}
}
@article{SchusterJohannsenSchneiderbangeretal.2013,
  author    = {Schuster, Frank and Johannsen, Stephan and Schneiderbanger, Daniel and Roewer, Norbert},
  title     = {Evaluation of suspected malignant hyperthermia events during anesthesia},
  series = {BMC Anesthesiology},
  journal   = {BMC Anesthesiology},
  doi       = {10.1186/1471-2253-13-24},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96231},
  year      = {2013},
  abstract  = {Background Malignant hyperthermia (MH), a metabolic myopathy triggered by volatile anesthetics and depolarizing muscle relaxants, is a potentially lethal complication of general anesthesia in susceptible patients. The implementation of modern inhalation anesthetics that research indicates as less potent trigger substances and the recommended limitations of succinylcholine use, suggests there may be considerable decline of fulminant MH cases. In the presented study, the authors analyzed suspected MH episodes during general anesthesia of patients that were referred to the Wuerzburg MH unit between 2007 and 2011, assuming that MH is still a relevant anesthetic problem in our days. Methods With approval of the local ethics committee data of patients that underwent muscle biopsy and in vitro contracture test (IVCT) between 2007 and 2011 were analyzed. Only patients with a history of suspected MH crisis were included in the study. The incidents were evaluated retrospectively using anesthetic documentation and medical records. Results Between 2007 and 2011 a total of 124 patients were tested. 19 of them were referred because of suspected MH events; 7 patients were diagnosed MH-susceptible, 4 MH-equivocal and 8 MH-non-susceptible by IVCT. In a majority of cases masseter spasm after succinylcholine had been the primary symptom. Cardiac arrhythmias and hypercapnia frequently occurred early in the course of events. Interestingly, dantrolene treatment was initiated in a few cases only. Conclusions MH is still an important anesthetic complication. Every anesthetist must be aware of this life-threatening syndrome at any time. The rapid onset of adequate therapy is crucial to avoid major harm and possibly lethal outcome. Dantrolene must be readily available wherever MH triggering agents are used for anesthesia.},
  language  = {en}
}