Hipertermia Maligna: Tinjauan Pustaka
Tinjauan Pustaka
DOI:
https://doi.org/10.55175/cdk.v53i06.1746Kata Kunci:
Anestesi, dantrolene, reseptor dihydropyridine, hipertermia malignaAbstrak
Hipertermia maligna (HM) adalah sindrom yang dapat mengancam nyawa disebabkan oleh pemberian agen anestesi volatil dan relaksan otot depolarisasi seperti succinylcholine, berupa peningkatan metabolisme otot rangka yang tidak terkendali. Kondisi MH disertai pembukaan saluran kalsium pada membran retikulum sarkoplasma (SR), yang memicu kontraksi otot berlebihan, peningkatan suhu, dan gangguan metabolisme. Basis genetik MH dikaitkan dengan mutasi gen CACNA1S yang mengkode subunit reseptor dihydropyridine (DHPR), protein-protein penting untuk regulasi kalsium otot. Kondisi ini sering dipicu selama operasi yang membutuhkan anestesi umum atau regional, terutama pada individu yang memiliki riwayat keluarga MH. Manifestasi klinis dapat berupa hiperkapnia, takikardia, asidosis, rabdomiolisis, hingga disfungsi multiorgan. Diagnosis dini sering kali menjadi tantangan karena HM memiliki gejala yang menyerupai kondisi hipermetabolik lainnya dan dapat berkembang dengan cepat apabila tidak segera ditangani. Pengobatan meliputi pemberian dantrolene, yang berfungsi sebagai relaksan otot pasca-sinaptik untuk mengurangi coupling eksitasi-kontraksi (ECC) pada sel otot dan mengurangi hipermetabolisme. Pengenalan dini dan pemberian dantrolene segera sangat penting untuk keberhasilan penatalaksanaan.
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