MUSCLE BIOPSY FOR MALIGNANT HYPERTHERMIA SCREENING IN CHILDREN

Malignant Hyperthermia (MH) remains a life-threatening event in anaest hetic practice. In paediatric patients, triggering agents such as vola tile anaesthetics and other succinylcholine are widely used. For child ren with a positive family history or previous clinical signs of MH, m uscle biopsy for the halothane and caffeine in vitro muscle contractur e tests is the only reliable procedure for diagnosis of MH susceptibil ity. Here we investigated outcome and compliance of patients and paren ts involved in the test. Twenty-four children between 6 and 14 yrs of age were admitted to hospital for biopsy. Muscle withdrawal was perfor med at the upper leg from lateral vastus muscle using regional or trig ger-free general anaesthesia. Outcome and compliance were controlled b y a telephone interview or direct physical re-evaluation.Seventeen pat ients out of 24 were diagnosed as clinically MH-susceptible according to the protocol of the European MH Group. Seven children were excluded as MH-negative by the test. Twenty-one children were evaluated postop eratively. Minor side effects of wound healing occurred, but none of t he patients showed any abnormalities of muscle contracture or movement performance. Considering the high risk of fatal complications in the presence of MH-susceptibility, muscle biopsy of the upper leg for in-v itro diagnosis is a justified procedure that is acceptable to children and their parents.