Henry Rosenberg, M.D., Medical Director for MHAUS and Professor and Chair of Anesthesiology, Medical College of Pennsylvania and Hahnemann University, explains, "The Grand Rounds program is designed to evaluate and compare clinical options related to MH susceptibility testing, clinical diagnosis, and perioperative management of malignant hyperthermia."
Actual and hypothetical case histories are presented by experts in the recognition and treatment of MH. Gerald A. Gronert, M.D., Professor and Vice Chair of Anesthesiology, University of California School of Medicine, details the challenges of diagnosing MH. He discusses the management of a healthy 11 year old patient presented for elective tonsillectomy who suffered a sudden cardiac arrest after succinylcholine. Although the patient experienced many MH symptoms, she tested negative on a subsequent MH muscle biopsy test.
Denise J. Wedel, M.D., Associate Professor of Anesthesiology, Mayo Clinic, reviews a case of a 6 year old male, diagnosed with congenital anthrogryposis, who underwent surgery for a hand deformity. The patient had received one prior general anesthetic with no complications and developed masseter rigidity and a full-blown MH episode after being induced with halothane.
Dr. Rosenberg addresses the management of patients with a family history of MH. He states, "Identifying a patient history suggestive of MH-susceptibility prior to surgery allows the selection of safe anesthetics for surgery and the opportunity to confirm MH-susceptibility by biopsy."
He details three case histories to illustrate this section. The first case history discusses a patient presented for elective surgery whose brother had died during an operation after an uncomplicated anesthesia and unexplained high fever. In the second case, he describes a patient scheduled to undergo surgery for a bowel obstruction. In a prior operation, he awoke in the ICU packed in ice. He was told that he had developed masseter muscle rigidity with succinylcholine and that he night have suffered a mild MH episode. In the third case, a patient presented for an elective procedure required ventilation for 6 hours during a prior tonsillectomy when he was 10. He was weak for a day, but fully recovered, and was concerned about MH and his impending surgery.
Supported by an educational grant from Zeneca Pharmaceuticals, the Grand Rounds videotape is available free of charge by contacting MHAUS at 1-800-98-MHAUS or by writing MHAUS, 32 South Main Street, Box 1069, Sherburne, NY, 13460-1069.