Acta Biomedica Scientifica (Sep 2017)
Malignant hyperthermia: current approaches to prevention and treatment
Abstract
One of the most serious complications of modern anesthesia is malignant hyperthermia, which is a pharmacogenetic disease phenotype manifested by skeletal muscle hypermetabolism and rhabdomyolysis during or after general anesthesia with the use of inhaled anesthetics and succinylcholine. In Russia, the problem of malignant hyperthermia remains unresolved. This is mainly due to the fact that the only specific drug dantrolene created for the effective treatment of malignant hyperthermia is still not legalized and thus formally prohibited to import, disseminate and apply on the domestic pharmaceutical market. This article deals with the regulatory framework of specific treatment of malignant hyperthermia in Russia, allowing the possibility to legally import to the territory of the Russian Federation dantrolene as an unregistered drug, if it is a question of rendering medical assistance on vital indications to a particular patient, or its unauthorized use for vital indications in a situation of extreme necessity. The article presents the recommendations of domestic experts on the treatment of malignant hyperthermia. In this case, as a possible alternative to dantrolene, magnesium preparations are considered, whose role in the treatment of the crisis of malignant hyperthermia continues to be specified. Thus, given the increasing use of inhalation anesthesia by Russian anesthetists, to ensure the safety of patients with regard to the development of malignant hyperthermia, it is possible only in the case of official registration in the domestic dantrolene market. Also, in the territory of Russia, a network of relevant consultative and diagnostic centers should be established. These measures will undoubtedly increase the effectiveness of treatment and prevention of severe consequences of this disease in our country.
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