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Exertional Illnesses Linked to Anesthesia Complication

Last Updated: September 29, 2009.

Possible links exist between heat- and exercise-related illnesses that strike even the physically fit and a feared complication of anesthesia, according to a review in the October issue of Anesthesia & Analgesia.

TUESDAY, Sept. 29 (HealthDay News) -- Possible links exist between heat- and exercise-related illnesses that strike even the physically fit and a feared complication of anesthesia, according to a review in the October issue of Anesthesia & Analgesia.

John F. Capacchione, M.D., and Sheila M. Muldoon, M.D., from the Uniformed Services University of the Health Sciences in Bethesda, Md., reviewed the literature for links between exertional heat illness and exertional rhabdomyolysis, two heat- and exercise-related illnesses that can affect even physically fit people, such as military recruits, and malignant hyperthermia, a rare complication where healthy patients have a sudden increase in temperature after receiving anesthesia.

The researchers found that, while no controlled clinical studies exist linking the three illnesses, multiple case reports and some small clinical studies have suggested that unexpected intolerance to heat and exercise are associated with susceptibility to malignant hyperthermia based on in vitro muscle contracture testing and/or genetic testing. Individuals have developed malignant hyperthermia while exercising and without exposure to anesthesia and were found to have a genetic abnormality associated with malignant hyperthermia. They note that, while tests exist for clinical malignant hyperthermia in association with anesthesia, the tests are not validated for exertional heat illness or exertional rhabdomyolysis.

"These relationships may have implications for some malignant hyperthermia-susceptible patients and their capacity to exercise, as well as for clinicians treating and anesthetizing patients with histories of unexplained exertional heat and exercise illnesses," Capacchione and Muldoon conclude.

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