What concerns are there for the patient with an ion channel disease who must have anesthesia for surgery?
MALIGNANT HYPERTHERMIA Patients with ion channel diseases are at increased risk of malignant hyperthermia reactions with general anesthesia for surgery. In malignant hyperthermia, muscle cells become overactive (hypermetabolic) in response to the most commonly used drugs for general anesthesia. With inhaled agents (such as halothane, isoflurane, enflurane, desflurane, sevoflurane and even agents such as ether, cyclopropane and methoxyflurane ) the ion channels in the muscle cells open and remain open. This results in excessive calcium release causing muscles to continuously contract, producing massive amounts of heat, rapid rise in temperature and disruption of nearly every organ system in the body. In the past this reaction was fatal in 70% of cases. However, with the introduction of the medication, dantrolene, the mortality has now fallen to 5% of cases. It is essential that anesthetists and surgeons are made aware that a patient has periodic paralysis or even that a parent suffers w
