CREATINE-KINASE ALTERATIONS AFTER ACUTE MALIGNANT HYPERTHERMIA EPISODES AND COMMON SURGICAL-PROCEDURES

Skeletal muscle may release creatine kinase (CK) during a malignant hy perthermia (MH) episode; however, muscle damaged during surgery may al so release CK. This study examined the overlap between peak plasma CK levels in patients suspected of having had a MH episode (data obtained from North American MII Registry) and previously published CK changes occurring after common surgeries. For patients who were subsequently proven to be MH positive by muscle biopsy, there was considerable over lap. This was most significant with surgeries having substantial tissu e damage, such as major vascular surgery and abdominal surgery. Overla p was much less with minimally invasive surgery, such as cystoscopy. A pproximately 30% of MH positive patients treated with dantrolene had p eak CK in the range of most surgical procedures, and approximate to 50 % of MH positive patients not given succinylcholine had peak CK simila r to those of most surgical procedures. Dantrolene did not significant ly alter peak CK in MH positive patients; however, succinylcholine was associated with significantly higher peak CK. These data suggest that patients who have had an acute MH episode during a surgical procedure may have peak CK values within the range of CK values expected from t he procedure itself.