Anesthesia and analgesia
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Anesthesia and analgesia · Jun 1983
Spectrum of susceptibility to malignant hyperthermia--diagnostic dilemma.
Utilizing established in vitro muscle contracture tests, we have identified three diagnostic contracture phenotypes for malignant hyperthermia susceptibility (MHS) among 103 patients. Phenotype H is an unequivocal diagnostic result for MHS, as is the nonsusceptible phenotype N. The third diagnostic group, phenotype K, represents an equivocal diagnostic response. ⋯ Comparing phenotype H v K average responses, VO2 increased four- v twofold; lactate increased 13- v 9-fold; and temperature increased 41.7 degrees C v 39.2 degrees C, respectively. These values either had no change or decreased in the phenotype N pigs. Results of this study suggest that a spectrum of MHS exists among the human population.
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Anesthesia and analgesia · May 1983
Effects of myocardial infarction on perioperative cardiac complications.
Of 1104 consecutive noncardiac operations on 981 patients using general anesthesia, 63 were performed on 53 patients who had had a previous myocardial infarction. Patients with a previous infarct were compared to those with no prior infarct to determine the influence of a previous infarct on perioperative cardiac complications. Two of the 53 patients with a previous myocardial infarction (3.8%) had perioperative myocardial infarction, compared to 0.4% (4/928) of patients with no prior history of myocardial infarction (P less than 0.05). ⋯ All patients with a previous myocardial infarction who developed cardiac complications underwent vascular procedures (P less than 0.005) and were over 77 years of age. The two patients who reinfarcted experienced intraoperative hypotension (P less than 0.05). Fourteen of the 53 patients with a history of a myocardial infarction (26.4%) had previous coronary artery bypass surgery; no perioperative cardiac complications occurred in these patients.