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Journal of Anesthesia

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01-08-2012 | Original Article

Calcium channel blockers are inadequate for malignant hyperthermia crisis

Authors: Takako Migita, Keiko Mukaida, Toshimichi Yasuda, Hiroshi Hamada, Masashi Kawamoto

Published in: Journal of Anesthesia | Issue 4/2012

Abstract

Purpose

Malignant hyperthermia (MH) results from disordered calcium (Ca²⁺) homeostasis in skeletal muscle during general anesthesia. Although Ca²⁺ channel blockers may be given to treat the tachycardia and circulatory instability, coadministration of Ca²⁺ channel blockers and dantrolene is contraindicated during MH crisis. We evaluated the effect of Ca²⁺ channel blockers on Ca²⁺ homeostasis and their interactions with dantrolene in human skeletal muscle.

Methods

Human skeletal muscle samples were obtained by biopsy and divided into two groups according to the results of the Ca²⁺-induced Ca²⁺ release rate test. Differentiated myotubes were labeled with Fura-2, and changes in the 340/380-nm ratio were used to calculate changes in Ca²⁺ concentration following nifedipine treatment in the absence or presence of dantrolene.

Results

Nifedipine induced a transient increase in the intracellular Ca²⁺ concentration ([Ca²⁺]_i) in a dose-dependent manner. The half-maximal concentration (EC₅₀) for nifedipine was 0.718 ± 0.329 μM in the accelerated group and 1.389 ± 0.482 μM in the nonaccelerated group (P = 0.009). The addition of 50 μM dantrolene attenuated by 15.4% the increase in [Ca²⁺]_i caused by the 0.5 μM nifedipine.

Conclusion

Ca²⁺ channel blockers led to increased [Ca²⁺]_i in human skeletal muscle cells. The increase is thus scarcely affected by dantrolene treatment. Data provide a greater physiologic basis for avoiding the use of Ca²⁺ channel blockers during MH crisis.

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Title: Calcium channel blockers are inadequate for malignant hyperthermia crisis
Authors: Takako Migita
Keiko Mukaida
Toshimichi Yasuda
Hiroshi Hamada
Masashi Kawamoto
Publication date: 01-08-2012
Publisher: Springer Japan
Published in: Journal of Anesthesia / Issue 4/2012
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-012-1347-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Calcium channel blockers are inadequate for malignant hyperthermia crisis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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