Malignant Hyperthermia - 8
The Caffeine-Halothane Contracture Test (CHCT)

• the current "gold standard" test for MH.
• recently standardized in North America
• the usual biopsy site is the quadriceps muscle (vastus lateralis or medialis)
• Because of the size of the biopsy (2 Grams), it is recommended that patients weigh at least 20 kg. Most centers will not biopsy patients < 5 yrs old.
• 2 to 3 months should have elapsed since the most recent (presumed) MH episode
• anesthesia for biopsy
  • use nontriggering agents
  • regional anesthesia often used (nerve blocks or neuraxial block)
  • avoid direct infiltration of muscle with local anesthetic
• dantrolene should be avoided
• the muscle tissue should be handled as little as possible and not stretched
• the test should be performed within 5 hours after the biopsy
• costs approximately $6,000 - $10,000 (covered by most US health insurance companies)

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