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Abstracts: Third Meeting of the International Society for Medical Gases (ISMG); Heidelberg, Germany, 29 September-1 October 1999

No evidence that xenon triggers malignant hyperthermia in humans

Baur, C. P.1,2; Klingler, W.1,2; Froeba, G.1; Marx, T.1; Georgieff, M.1; Lehmann-Horn, F.2

Section Editor(s): Graf, B. M.; Weimann, J.

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European Journal of Anaesthesiology: 2000 - Volume 17 - Issue - p 6-7

ABSTRACT NO: 012

Introduction: Since its first use for anaesthesia in humans in 1951, xenon has been regarded as an ideal anaesthetic agent, because of its lack of cardiovascular depression and its fast induction and recovery from anaesthesia [1]. It is known that volatile anaesthetics may trigger malignant hyperthermia (MH). An agent lacking this feature would be of great value with regard to patient safety. Therefore, we investigated the effect of xenon on muscle strips of malignant hyperthermia susceptible (MHS) and negative (MHN) individuals in vitro.

Methods: On muscle strips of 30 individuals referred to the Malignant Hyperthermia Unit in Ulm, the in vitro contracture test (IVCT) as the gold standard for MH testing was carried out according to the European Protocol [2]. An increase in baseline tension as a result of exposure to trigger agents indicates MH susceptibility. The reaction of muscle specimens to exposure to 70% xenon, the highest concentration clinically used, was investigated.

Results: According to the IVCT, 12 individuals were found to be MHS and 18 MHN. Following the exposure to xenon, no elevation of baseline tension of the muscle strips-the criterion of MH susceptibility-was found.

Conclusions: Froeba et al. proved that xenon does not trigger malignant hyperthermia in vivo in susceptible pigs [3]. Because, in the IVCT, the in vitro exposure of human MHS muscle specimens to the highest clinically used concentration of xenon (70%) caused no baseline alterations typical for MH, we conclude that xenon triggers malignant hyperthermia neither in susceptible pigs nor in susceptible humans.

References:

1 Cullen SC, Gross EG. Science 1951; 113: 580-582.
2 European Malignant Hyperpyrexia Group. Br J Anaesth 1984; 56: 1267-1269.
3 Froeba G, Marx T, Panchur JR et al. Anesthesiology 1999; 91: 1047-1052.

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The publication of this supplement has been supported by the sponsors of the Third ISMG Meeting: Abbott, AGA, AstraZeneca, Dräger, Janssen, Medex Medical, Messer Austria, Ohmeda, Pharmacia & Upjohn, Scott Medical Products, Siemens

© 2000 European Society of Anaesthesiology