[Should the use of succinylcholine in pediatric anesthesia be re-evaluated?].

We report on the occurrence of cardiac arrests within a few minutes following succinylcholine in 9 children, all of whom were later shown to have occult neuromuscular disease. Five of the children did not survive the catastrophic event. The anaesthetist in most cases, when discussing premedication, got the impression that the patients were in good health; just in 2 children were there indications of myopathy.

[An attempt to reconcile differences of opinion in the field of malignant hyperthermia].

Two of the persisting controversies concerning malignant hyperthermia (MH) are discussed: storing and dosage of dantrolene and preoperative tactics to be followed with patients who are MH-susceptible. Reasons are presented for the obligation to store sufficient amounts of dantrolene in every operating suite. The second part discusses the question of pretreatment of MH-susceptible patients with dantrolene.

[Reasons for the persistent lethality of malignant hyperthermia and recommendations for its reduction].

Dantrolene is the only known specific treatment of malignant hyperthermia (MH). Following official approval an intravenous formulation of dantrolene became clinically available for emergency treatment of MH. At that time it had been anticipated, that with dantrolene therapy combined with constant vigilance each case of MH could be treated successfully and the mortality rate should be close to zero.

Transdermal fentanyl for the treatment of pain after major urological operations. A randomized double-blind comparison with placebo using intravenous patient-controlled analgesia.

Transdermal fentanyl 75 micrograms/h (Fentanyl-TTS) was compared with placebo in a randomized double-blind study in the early postoperative period, using 50 patients recovering from major urological operations. Analgesic efficacy was individually titrated with intravenous fentanyl by means of a PCA pump (demand dose 34 micrograms, lockout time 5 min). The test systems were applied 8 h before anaesthesia and were left in situ for 24 h.

["Round the clock"--an information service for malignant hyperthermia emergencies].

A 24-hour 7-day telephone service has been created for emergency consultation: MH-hotline 030/3035504 (daytime) or 030/30351 (after office hours). In emergencies callers should ask for a consultant, indicating the code word "malignant hyperthermia" and give their name, the name of the institution and the telephone number.

[New findings and experiences in the field of malignant hyperthermia].

New publications on malignant hyperthermia (MH), with direct clinical importance, are reported. Since even in the recent past patients have died from MH in spite of therapy with dantrolene, the effectiveness of dantrolene is discussed in particular. Atypical clinical pictures of MH are presented.

[Dantrolene in the treatment of life-threatening psychiatric disease pictures. A contribution to the therapy of the malignant neuroleptic syndrome and acute febrile catatonia].

The malignant neuroleptic syndrome and acute febrile catatonia are life-threatening psychiatric disorders which frequently are treated in intensive care units outside psychiatric departments. Their manifestations are very similar to those of anaesthesia-specific malignant hyperthermia. The three syndromes have in common signs of increased muscle metabolism.

Postoperative malignant hyperthermia and dantrolene therapy.

A case of malignant hyperthermia (MH) in a three-year eight-month-old girl is presented. Definite symptoms of MH developed in the awake patient 30 min after termination of anaesthesia which had lasted five hours. This postoperative MH-episode resolved promptly following intravenous administration of dantrolene (2.

[Malignant hyperthermia].

Malignant hyperthermia (MH) is a rare syndrome seen when susceptible individuals are exposed to one or more of various triggering agents, most commonly a depolarizing muscle relaxant or an inhalational anaesthetic agent. There is a dramatic rise in metabolic rate and oxygen consumption which if not treated promptly and effectively results, in the majority of cases, in the patient's death. Fatal responses to physical stress associated with the familial muscular disease known as MH are being increasingly reported in situations not related to anaesthesia or drugs.

[Cyanosis as a result of drug-induced methemoglobinemia. A case report].

A 39-old, anaemic woman, admitted to hospital because of a fistula between bladder and bowel, developed a moderate degree of methaemoglobinaemia (19% of total haemoglobin) after prescription of 3 X 200 mg/die phenazopyridine (Pyridium) for 4 weeks. She showed a greyish discoloration of the skin; lips and nailbeds were cyanosed. On the basis of a glucose-6ph-dehydrogenase deficiency (71 mU/10(9) RBCs instead of 131 +/- 13 mU/10(9) RBCs - the normal value for adults) the medication with phenazopyridine induced methaemoglobinaemia.

[Monitoring of cerebral electrical activity during cardiac surgery (author's transl)].

Continuous recording of cerebral activity by the Cerebral Function Monitor is a useful supplementation to anaesthetic monitoring in cardiac surgery. It is a simple and reliable method for early detection of cerebral damage during heart surgery and in other situations with possible cerebral impairment. The operating principles of the Cerebral Function Monitor and the interpretation of the electrical activity tracings are presented.

Comparison of intravenous acetylsalicylic acid and dipyrone in postoperative pain: an interim report.

1 In 17 gynaecological patients with postoperative pain the analgesic efficacy of intravenous lysine salicylate 1.8 g (corresponding to acetylsalicylic acid (ASA) 1.0 g) and dipyrone 1.