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MH discovered at The Royal Melbourne Hospital
The Royal Melbourne could be considered the birthplace of knowledge about malignant hyperthermia – a potentially fatal disorder that can occur under certain types of anaesthetic.
At the RMH in 1960 malignant hyperthermia was first identified as a genetically inherited disorder. A young man who was to have orthopaedic surgery was understandably terrified of the anaesthetic, as 10 members of his family had died during other procedures involving general anaesthesia. Dr Jim Villiers was the anaesthetist who recognised the disorder and successfully anaesthetised the patient for his procedure. Doctors Michael Denborough and Richard Lovell outlined the autosomal dominant inheritance of this severe reaction to anaesthetics and their letter was published in The Lancet.
Since 1972, The Royal Melbourne Hospital has been providing an advice, research and testing service for this rare but important disease, which has significant anaesthetic and surgical consequences.
The unit has tested more than 350 patients and there have been over 700 referrals. RMH is one of only three testing centres in Australia. The unit has been under the control of the Department of Anaesthesia and Pain Management since May 2001.
The only recognised test for malignant hyperthermia is a muscle biopsy, which is performed under a “non-triggering” anaesthetic. It involves a day’s stay in hospital and a few days off work while the 5cm scar on the thigh heals. While the test is accurate, it involves a certain degree of discomfort and cannot be performed on children as their muscle mass is not large enough.
Because of the limitations of the muscle biopsy, malignant hyperthermia testing centres throughout the world have been trying to devise another, less invasive test. A limited amount of genetic testing is also available for some families. |
