EENT and Sleep Disorders Q 22 - Gyan Darpan : Learning Portal
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Wednesday 23 March 2022

EENT and Sleep Disorders Q 22

The patient’s chart notes the administration of dantrolene (Dantrium) immediately postoperatively. The nurse suspects that the patient experienced:
     A. Delirium tremens
     B. Malignant hyperthermia
     C. A tonic-clonic seizure
     D. Respiratory arrest

Correct Answer: B. Malignant hyperthermia

Dantrolene is a direct-acting musculoskeletal muscle relaxant and is the drug of choice to treat malignant hyperthermia, a complication of generalized anesthesia. Dantrolene sodium (sold under a variety of trade names) is a postsynaptic muscle relaxant with multiple indications in the fields of anesthesiology and neurology. Among the many indications for the use of dantrolene, its primary indication, and FDA-approved usage in both children and adults, is for the treatment of malignant hyperthermia: the very rare but life-threatening disorder triggered by general anesthesia.

Option A: The most common and validated treatment for alcohol withdrawal is benzodiazepine. There are several benzodiazepines that can be used, ranging from lorazepam (Ativan), diazepam (Valium), to chlordiazepoxide (Librium), preferably administered via an intravenous route.
Option C: A benzodiazepine (intramuscular midazolam, intravenous lorazepam, intravenous diazepam, intranasal midazolam, or rectal diazepam) is the initial therapy of choice. If seizures continue for more than 20 minutes, second-line therapy should be initiated.
Option D: The goal in respiratory arrest is to maintain adequate tissue oxygenation, generally achieved with an arterial oxygen tension (PaO2) of 60 mm Hg or arterial oxygen saturation (SaO2), about 90%. The choice of invasive or noninvasive ventilatory support depends on the clinical situation, whether the condition is acute or chronic, and how severe it is. It also depends on the underlying cause.

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