2. Mr. Bond is a 32-year-old Caucasian man who plays professional football. He w
ID: 278205 • Letter: 2
Question
2. Mr. Bond is a 32-year-old Caucasian man who plays professional football. He was admitted for repair of a rotator cuff injury sustained in a game. In excellent shape, Mr. Bond has a muscular build and his body fat is 18%. Mr. Bond is transferred to the operating room, and the anesthesiologist begins to administer general anesthesia. During the induction of anesthesia, Mr. Bond develops tachycardia and dysrhythmias. His decreased cardiac output. The anesthesiologist states that Mr. Bond is developing malignant hyperthermia. (Learning Objective 5) condition continues to deteriorate and he becomes severely hypotensive and exhibits a. What risk factor does Mr. Bond have for malignant hyperthermia? b. What clinical manifestations of malignant hyperthermia does Mr. Bond demonstrate? c. Based on the patient's condition, the surgical procedure is stopped and 100% oxygen is started. Additionally, a muscle relaxant and sodium bicarbonate are administered. What are the rationales for these medications?Explanation / Answer
a) The risk factor for malignant hyperthermia includes the exposure to anasthetic drugs/ volatile gases such as halothane, elflurane etc. It can cause tachycardia(very high heart rate), decresed cardiac output,
The the concentration of the triggeri ng agent in the anasthetic drug to which the patient is succeptible should be low.
b) Clinical manifestations of malignant hypothermia that Mr Bond displays after administering anasthetics are-
Tachycadia(abnormal rapid breathing
Decreased cardiac output
Dysrhythmia(abnormal biological rhythm)
Hypotension(lowering of BP)
c) Oxygen consumption also increase in malignant hyperthermia thus 10% oxygen is required.
Muscle relaxant is given to relax muscle rigidity since this is linked with rhabdomyolysis which leads to breakdown of damaged skeletal muscles, caused due to excessive intracellular calcium release from sarcoplasmic reticulum of muscles.
Sodium bicarbonate is given to reduce the metabolic acidosis that results from increased CO2 production.
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