Patient with hypermetabolic response of skeletal musculature by causes related with Malignant Hyperthermia in the literature.

50 variants have been described that can be considered "diagnostic mutations" of RYR1 and CACNA1S, and other under study.

Hyperthermia, Malignant

In vitro study of muscle contraction after exposure to different substances (caffeine and halothane).

In vitro contracture test (IVCT)

In vitro study of the activation of lymphocytes B after being incubated with a cocktail of primary antibodies and measuring the acidification in response to the RyR1, 4-CmC agonist, using ryanodine as a positive control.

In vitro test of hypermetabolism in B lymphocytes

Analysis of genes related to MH (CACNA1S and RYR1).

Genetic test

Hospital Universitario La Paz

Population at Risk of Malignant Hyperthermia: Ambispective Cohort.

Measured by the tension induced by the muscular contraction in response to the presence of caffeine and halothane.

Identifying determined genes related with Malignant Hyperthermia risk.

Extracellular acidification curve in B lymphocytes in response to the agonist RyR1 and 4-CmC.

Instituto de Investigación Hospital Universitario La Paz

Universidad Autonoma de Madrid

1. Anesthesia-sedation KETOFOL 1-1: Two milligrams per kilogram of ketamine plus two milligrams per kilogram of propofol in a solution 1:1 (one milligram of ketamine per one milligram of propofol) was given to those patients randomly asigned to this group, who were scheduled for any short surgical procedures previously defined in the inclusion criteria.

2. Anesthesia-sedation KETOFOL 1-2: One milligram per kilogram of ketamine plus two milligrams per kilogram of propofol in a solution 1:2 (one milligram of ketamine per two milligrams of propofol) was given to those patients randomly asigned to this group, who were scheduled for any short surgical procedure previously defined in the inclusion criteria.

Anesthesia; Reaction

After randomization to the study group, the patients were given:
Procedures < 10 minutes
Ketamine-Propofol Combination KETOFOL 1:1
Propofol: 0.2 cc/kg (10 mg/cc = 2 mg/kg)
Ketamine: cc/kg 0.04 (50 mg/cc = 2 mg/kg)
Simple 1% lidocaine: 0,1 cc/kg (10 mg/cc = 1 mg/kg)
Ketamine-Propofol Combination KETOFOL 1:2
Propofol: 0.2 cc/kg (10 mg/cc = 2 mg/kg)
Ketamine: 0.02 cc/kg (50 mg/cc = 1 mg/kg)
Simple 1% lidocaine: 0,1 cc/kg (10 mg/cc = 1 mg/kg)
Procedures > 10 minutes
In addition to the initial bolus, an infusion was started:
KETOFOL 1:1
20 cc of propofol (10 mg/cc = 200 mg in total) 4 cc of ketamine (50 mg/cc = 200 mg in total) 10cc lidocaine 1% simple (10 mg/cc = 100 mg in total) 66 cc 0.9% SSN
KETOFOL 1:2
20 cc of propofol (10 mg/cc = 200 mg in total) 2 cc of ketamine (50 mg/cc = 100 mg in total) 10cc lidocaine 1% simple (10 mg/cc = 100 mg in total) 68 cc 0.9% SSN
Speed infusion:
0,03cc/kg/min

Ketamina-Propofol Combination

Efficacy of Ketamine-Propofol for Short Surgical Procedures

EFFICACY OF KETAMINE-PROPOFOL COMBINATION FOR SHORT SURGICAL PROCEDURES

Sedation / analgesia was considered successful if the procedure was completed without the need for other anesthetic drugs are different from the protocol, and yes no adverse effects to oblige the completion of the procedure. Apnea was defined as cessation of breathing for at least 20 seconds. Hypotension was defined as 20% decrease in mean arterial pressure. Bradycardia was defined as a pulse of less than two standard deviations below normal values defined by the American Heart Association (AHA_ for its acronym in Ingles_). Hypoxia was defined by an oxygen saturation of less than 90%.

malignant hyperthermia/hypoxie

Population at Risk of Malignant Hyperthermia: Ambispective Cohort.

Efficacy of Ketamine-Propofol for Short Surgical Procedures

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