Year: 2025 | Month: January | Volume: 15 | Issue: 1 | Pages: 143-149
DOI: https://doi.org/10.52403/ijhsr.20250119
Malignant Hyperthermia: The Perioperative Nurse's Role
Sevgi GÜR1, Nurgül ARPAG2
1Lecturer, PhD., Selçuk University, Faculty of Nursing, Department of Surgical Nursing, Konya, Türkiye.
2Asst. Prof., Istanbul Atlas University, Faculty of Health Sciences, Department of Nursing, Istanbul, Türkiye.
Corresponding Author: Sevgi GÜR
ABSTRACT
The malignant hyperthermia (MH), a rare but life-threatening condition triggered by certain anaesthetic agents in patients with a genetic predisposition. MH is characterised by a hypermetabolic response, leading to symptoms including increased carbon dioxide levels, muscle rigidity, irregular heart rhythms, and hyperthermia. Epidemiological data indicate a higher prevalence in children, males, and specific populations such as those of French, Scandinavian, and Japanese origin. The diagnosis of MH is challenging and the gold standard is the halothane-caffeine muscle contracture test, though genetic testing is also utilised. However, not all associated gene mutations are fully identified and testing can be costly and invasive. Risk factors include age, genetics, type of anesthetic agents, and environmental triggers. The symptoms manifest in two distinct phases: the early phase, characterised by elevated end-tidal carbon dioxide levels, muscle spasms, and metabolic acidosis; and the late phase, marked by hyperthermia, rhabdomyolysis, and cardiac arrhythmias. Effective management of MH necessitates two fundamental components: the early recognition of symptoms and the prompt response of a well-coordinated perioperative team. The immediate measures to be taken include the discontinuation of triggering agents, the administration of 100% oxygen, the initiation of active cooling measures, and the intravenous administration of dantrolene sodium to control the crisis. The monitoring of vital signs, electrolyte balance, and kidney function is crucial. Post-crisis care involves prolonged observation to prevent recurrence, rehabilitation, and patient education. The role of perioperative nurses is pivotal in identifying early signs, initiating rapid intervention, and providing ongoing care. Institutions must maintain protocols, ensure the availability of MH treatment trolleys, and provide regular training to staff. Risk assessments and identification of susceptible patients through family history or genetic testing are critical preventive measures. Early detection, prompt treatment, and coordinated care are essential to improving patient outcomes in MH cases.
Key words: Malignant hyperthermia, nursing care, surgical nursing.