Challenge of the Week / Basic Science / 4.22.2022

A patient undergoing orthopaedic surgery experiences acute decompensation intra-operatively that is mitigated with hyperoxygenation and serial injections of dantrolene. Susceptibility to which of the following conditions may be identified in this patient’s family?

    • Malignant hyperthermia
    • Malignant hyperthermia (MH) is a potentially fatal condition that occurs in susceptible individuals with an autosomal dominantly inherited mutation in skeletal muscle ryanodine receptors.

 

    • Fat embolism syndrome
    • Fat embolism syndrome (FES) is treated with supportive care that includes respiratory support, but dantrolene has no role in FES.

 

    • Lidocaine toxicity
    • Toxicities from local anesthetics, especially cardiac events, are treated with infusion of lipid emulsion.

 

    • Ischemia/reperfusion injury
    • Dantrolene has been sparsely studied in ischemia/reperfusion injuries to tissues other than skeletal muscle, but family history would not be contributory to ischemia/reperfusion injury.

     

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