Cerebral Metabolism during Porcine Malignant Hyperthermia

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Abstract
The cerebral response during halothane-succinylcholine anesthesia was examined in 6 malignant hyperthermia (MH)-susceptible and 2 normal swine. These values were also determined in a susceptible animal given pentobarbital prior to and during halothane-succinylcholine anesthesia and 2 susceptible animals in which MH was triggered by external warming. After the 50 min values had been obtained, biopsy specimens were taken from the brains of 5 animals. During MH induced by either drugs or warming, the cerebral metabolic rate for O2 was similar to that determined prior to induction of MH and to that determined for the normal swne. While cerebral blood flow immediately increased in the 6 animals with drug-induced MH following the introduction of halothane, no such increase occurred either in the pentobarbital-treated animal or in the animals where MH was induced by external warming. In brain biopsy specimens from the susceptible animals, increases in lactate and lactate/pyruvate and a decrease in phosphocreatine were consistent with changes in systemic variables such as temperature and acid-base indices. Considering the influences of systemic and other variables, the cerebral metabolic data suggests that the primary process(es) that generates MH does not occur in brain tissue and that MH itself does not cause gross irreversible brain-cell damage or cerebral metabolic failure.

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