Hipertermia maligna: uma revisão da literatura / Malignant hyperthermia: a literature review
DOI:
https://doi.org/10.34119/bjhrv3n2-096Keywords:
hipertermia maligna, revisão da literaturaAbstract
Estudar os efeitos adversos da succinilcolina e dos anestésicos inalatórios se faz muito importante, dado o uso cotidiano destes na anestesiologia. Nesse contexto, a hipertermia maligna é um evento adverso possível. Este artigo objetiva, assim, fornecer uma revisão da literatura com recomendações e considerações atualizadas com base na medicina baseada em evidências. É um estudo qualitativo de revisão narrativa, constituído por uma análise ampla da literatura, incluindo artigos de 1960 a 2019. Os termos utilizados para a estratégia de busca foram: “hipertermia maligna”, “succinilcolina” e “anestésicos inalatórios”. A succinilcolina e os anestésicos inalatórios são medicamentos frequentemente utilizados. A administração destes em pacientes com suscetibilidade pode ter efeitos deletérios, como a hipertermia maligna, a qual é uma doença neuromuscular de herança autossômica dominante que envolve déficits na liberação de cálcio. As manifestações clínicas clássicas são rigidez, lise muscular, acidose respiratória, aumento da temperatura e envolvimento cardíaco. Importantes fatores etiológicos são administração de succinilcolina e anestésicos inalatórios em pacientes suscetíveis, bem como calor e exercício físico. O teste de contratura muscular para exposição ao halotano-cafeína, por sua vez, pode ser utilizado para diagnóstico da suscetibilidade à hipertermia maligna. É imperativo no tratamento interromper a utilização de todos os anestésicos inalatórios e/ou succinilcolina, bem como tratar o paciente com dantrolene sódico. Deve-se direcionar tratamento individualizado, ainda, para cada manifestação clínica e laboratorial. Por fim, a medida preventiva mais importante é realizar boa história clínica, para antever miopatias e suscetibilidade à hipertermia maligna, de modo a pensar na utilização de outros medicamentos que não a succinilcolina e os anestésicos inalatórios.
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