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What is A 10-year old child is undergoing squint surgery. He suddenly developed increased hea rate, arrhythmia, high fever, metabolic and respiratory acidosis on aerial blood gases and elevation of end-tidal CO2. Which of the following would be the first agent of choice in the management of thiscondition? and explain in detail?
MH is a pharmacogenetic clinical syndrome that, in its classic form occurs during anesthesia with a volatile halogenated alkane such as halothane and/or the administration of the depolarizing muscle relaxant succinylcholine.The fulminant MH episode observed clinically produces rapidly increasing body temperature (by as much as 1deg C in 5 minutes) and extreme acidosis as a result of an acute loss of control of intracellular calcium levels and compensatory uncontrolled increases in skeletal muscle metabolism that may proceed to severe rhabdomyolysis. Although MH was initially associated with a moality rate of 60%, earlier diagnosis and the use of dantrolene have reduced the moality to less than 1.4%. Current cases of MH are restricted in severity because of diagnostic awareness, early detection through end-expired carbon dioxide (CO2), the use of less potent anesthetic triggers, and the administration of drugs that attenuate the progression of the fulminant episode. The incidence of fulminant MH was repoed to be 1 case per 62,000 anesthetics administered when triggering agents were not used, but the number of suspected cases was 1 case per 4500 anesthetics administered when triggering agents were administered. Clinical signs of malignant hypehermia: Treatment of malignant hypehermia: Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e