The most dangerous metabolic side effect of general anesthesia that can occur during surgery is:
A. Hyperglycemia
B. Hyperthermia
C. Hypoglycemia
D. Hypothermia
Correct Answer: B. Hyperthermia
Malignant hyperthermia is the most dangerous metabolic side effect of general anesthesia. Malignant hyperthermia is a severe reaction to certain drugs used for anesthesia. This severe reaction typically includes a dangerously high body temperature, rigid muscles or spasms, a rapid heart rate, and other symptoms. Without prompt treatment, the complications caused by malignant hyperthermia can be fatal. In most cases, the defective gene that puts you at risk of malignant hyperthermia is inherited, though sometimes it’s the result of a random genetic defect. Genetic testing can reveal whether you have an abnormal gene. This genetic disorder is called malignant hyperthermia susceptibility (MHS).
Option A: General anesthesia is more frequently associated with hyperglycemia and higher levels of catecholamines, cortisol, and glucagon than local or epidural anesthesia. Volatile anesthetic agents inhibit insulin secretion and increase hepatic glucose production.
Option C: Hypoglycemia is one of the most fatal complications during the perioperative period. General anesthesia or sedation can mask a hypoglycemia-altered mental status. Acute hypoglycemia might result in permanent brain injury.
Option D: Mild hypothermia is extremely common during anesthesia and surgery. The basic process occurs as core body heat redistributes to the skin surface through anesthetic-induced vasodilation and depression of hypothalamic thermoregulatory centers. Heat loss occurs mostly through the skin via radiation and convection.