Which of the following statements is true regarding management of an acute
episode of MH?
a) Reconstitute dantrolene in normal saline and administer at 2.5 mg/kg
intravenous over 5 minutes to maximum dose of 10 mg/kg
b) Active cooling is indicated if core body temperature is > 39 degrees Celsius
with ice packs in axilla and groin, intravenous cold saline solution or cold saline
lavage to a core temperature of 36 degrees Celsius
c) Correct metabolic acidosis with intravenous sodium bicarbonate 1-2 mEq/kg
as needed
d) Discontinue inhalation anesthetic and hyperventilate the patient using the
same anesthesia breathing system without any charcoal filter
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Answer
Answer c.
Any metabolic acidosis should be corrected with bicarbonate.
Dantrolene should be reconstituted in sterile water and not normal saline. In
case of hyperthermia (core temperature > 39 C) active cooling should be done to a
core temperature of 38 C. Discontinue inhalation anesthetic and hyperventilate
the patient with gas flow greater than 10 L/min of 100% oxygen. Place charcoal
filter on inspiratory and expiratory limbs of the breathing circuit or replace the
exposed elements of anesthesia breathing system or use a new non-rebreathing
system.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.
- See also MHAUS
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