Are you going to treat yourself or your child's teeth under inhalation anesthesia? It is necessary to weigh the pros and cons before treatment, to analyze the possible risks. And the first risk, which you can often read about in the media, is the so-called “death from anesthesia”.
Heritage bomb
No matter how incredible it may sound, the fact that inhalation anesthesia is contraindicated for you or your child is a possible “hello” from the ancestors. Who could live at a time when there was no anesthesia at all. But for some reason, one important gene began to mutate in them. From the outside, absolutely imperceptibly and painlessly, but the mutation was passed down from generation to generation. And when a person from this genetic chain was exposed to inhalation anesthesia, the “bomb” planted by the ancestors exploded. A person almost died or died not at all from anesthesia, but from malignant hyperthermia – a disease in which the body reacts negatively and violently to certain drugs used for inhalation anesthesia, up to death.
What are these reactions? A very rapid increase in body temperature to critical levels. Rapid heartbeat and very fast breathing. Rigidity, that is, stiffness of the muscles. In the classical form of the disease, these and a number of other symptoms appear almost immediately after the onset of anesthesia and increase over time.
Of course, not everything is always so scary. The form of malignant hyperthermia can be abortive, relieved. All the most dangerous happens when the disease proceeds at lightning speed, with all possible symptoms expressed brightly and convexly. However, even a lightweight version can cause a lot of problems for both the patient and the doctor.
Ghost Antidote
Is there really no escape from this scourge, you ask? There is salvation. An antidote is available. It's Dantrolene. It has been registered in Russia for a year now. And, in theory, it should be at hand for every anesthesiologist-resuscitator. But the idea is an idea, and the drug is far from being everywhere. There are many reasons for this, including purely bureaucratic ones. But one of the key problems is the anesthesiologists-resuscitators themselves. Many of whom still do not understand very well what malignant hyperthermia is. For them, this is a kind of mysterious, “mythical” disease, about which everyone seemed to have heard something, but they did not see it in their eyes. And since the disease is “mythical”, the medicine for it is not included in the number of purchases of the first stage. In order for the remedy to become necessary, the doctor must clearly understand what it saves from. But in our country there is still no official general register of cases when malignant hyperthermia became the cause of death. Many of us have seen terrible headlines in the press that a child died in the dentist's chair from inhalation anesthesia. But no one collects them in one list, alas. Why “alas”? Because when the doctor is convinced of the danger and unpredictability of malignant hyperthermia, he will do everything to ensure that his clinic has an antidote drug.
You can't breathe without breathing
The correct comma in this phrase can only be put by the patient himself or, if the patient is a child, the adult who decides on inhalation anesthesia. And in order to make a balanced decision, you need to have a certain amount of information. If possible, take specialized tests to understand if your ancestors gave you or your child such a “gift” as malignant hyperthermia. This time. Two – when discussing with the doctor the upcoming medical manipulations, ask if there is an antidote drug in the clinic. And if not, it is better to look for another medical institution. To minimize risks as much as possible.
If, however, hyperthermia nevertheless “crawled out” during inhalation anesthesia in a patient you are accompanying, the first principle is not to fuss. This applies to medical staff, patients, and accompanying persons. If you have the opportunity to quickly get and bring an antidote – do it. If there is no possibility, do not interfere with the doctors, they will look for him through their own channels. The clinic staff will do everything possible to “pull out” the most hopeless patient. But it is better, of course, to make sure in all possible ways that such a situation does not arise.
More details from ZG here https://malignanthyperthermia.rf
Clinics where there is an antidote https://dental-choice.ru/
Author: Bakhtier Almakhamatovich Ergashev (anesthesiologist-resuscitator of the Stvolygin Dental Center (Ivanovo))