Hipertermia maligna: uma revisão da literatura em Anestesiologia

Abstract

Malignant hyperthermia (MH) is a rare and potentially fatal autosomal dominant pharmacogenetic myopathy triggered by halogenated inhaled anesthetic agents and succinylcholine. The objective of this study is to review the scientific literature on malignant hyperthermia in the context of anesthesiology. To understand the nature of this rare, potentially fatal pharmacogenetic syndrome, identify risk factors, such as anesthetic agents, and its pathophysiology, related to impaired calcium homeostasis. The review seeks to identify the list of triggering agents and the population at risk; analyze clinical manifestations and diagnostic criteria; establish treatment and perioperative management strategies; and discuss national and international prevention protocols. Search sources include PubMed, SciELO, ScienceDirect, LILACS, and Google Scholar, covering publications from the last 15 years. The keywords used were: “malignant hyperthermia”, “dantrolene”, “anesthesia complications” and “hypermetabolic crisis”. Original articles, theses, reviews, and guidelines were included, and isolated case reports or articles not directly relevant to MH were excluded. Malignant hyperthermia is a potentially fatal genetic disease related to excessive muscle metabolism that occurs after exposure to inhalational anesthetics. The literature indicates that, despite its low incidence, MH remains a feared complication in anesthesia due to its fulminant progression. The availability of dantrolene and team training are critical factors in reducing mortality. Early recognition, combined with prompt administration of dantrolene, is crucial for survival. National and international protocols should be widely disseminated and implemented to ensure the safety of anesthetized patients.