2. Definition
It is a hypercatabolic syndrome associated with the
administration of general anaesthesia(short paralysis), and in
particular with use of suxamethonium(depolarising muscle
relaxant).
This condition is due to an inherited defect in the control of
calcium concentrations within the muscle cell. Abnormal and
incontrollable intracellular calcium n the skeletal muscle
induces hypermetabolic state in muscles leading to
hyperthermia.
Temperature above 41.5 degrees Celsius.
3. Causes
Genetic defect
Continuous muscle fasciculation/twitching caused by
anaesthetics agents and depolarising muscle relaxants before
producing neuromuscular blockade- which prevent muscular
contraction.
Infection; bacterial, parasitic or viral infection.
Intracranial haemorrhage- bleeding of the brain affecting the
hypothalamus in particular.
4. Nursing Assessment
An elevated body temperature , which continue to rise.
Tachycardia
Muscle rigidity
Hyperkalaemia
Acidosis due to excessive lactic acid production in the
skeletal muscle.
Elevated levels of creatine phosphokinase indicating
cellular and muscular damage
6. Nursing Management
Hyperthermia is treated with skeletal muscle relaxant which
stops the excessive contractile action that pushes temperature
up.
Remove excess blankets
Administer iced saline irrigations via rectal and nasogastric
tubes.
Give adequate fluids orally and intravenously to maintain
hydration and prevent kidney damage.
Monitor tissue damage by regular estimations of haemoglobin,
myoglobin and urinary myoglobin.
7. Cont.
The patient is dressed in light clothes or in
undressed.
Ventilation is improved by opening windows and
doors/ using electrical fans.
Tepid sponging
Educate the patient about the condition including
that wearing of MedicAlert bracelet is mandatory.
