Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Original Investigation

Fatigue, depression, and physical activity in patients with malignant hyperthermia: a cross-sectional observational study

Pâmela Vieira de Andrade, Lívia Maria Valim, Joilson Moura dos Santos, Isac de Castro, José Luiz Gomes do Amaral, Helga Cristina Almeida da Silva

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Malignant Hyperthermia (MH) is a pharmacogenetic disorder triggered by halogenated anesthesia agents/succinylcholine and characterized by hypermetabolism crisis during anesthesia, but also by day-to-day symptoms, such as exercise intolerance, that may alert the health professional.

The study aimed to analyze the incidence of fatigue in MH susceptible patients and the variables that can impact perception of fatigue, such as the level of routine physical activity and depression.

A cross-sectional observational study was carried out with three groups – 22 patients susceptible to MH (positivein vitro muscle contracture test), 13 on-susceptible to MH (negative in vitro muscle contracture test) and 22 controls (no history of MH). Groups were assessed by a demographic/clinical questionnaire, a fatigue severity scale (intensity, specific situations, psychological consequences, rest/sleep response), and the Beck depression scale. Subgroups were re-assessed with the Baecke habitual physical exercise questionnaire (occupational physical activity, leisure physical exercise, leisure/locomotion physical activity).

There were no significant differences among the three groups regarding fatigue intensity, fatigue related to specific situations, psychological consequences of fatigue, fatigue response to resting/sleeping, depression, number of active/sedentary participants, and the mean time and characteristics of habitual physical activity. Nevertheless, unlike the control sub-group, the physically active MH-susceptible subgroup had a higher fatigue response to resting/sleeping than the sedentary MH susceptible subgroup (respectively, 5.9 ± 1.9 vs. 3.9 ± 2,t-test unpaired, p <  0.05).

We did not detect subjective fatigue in MH susceptible patients, although we reported protracted recovery after physical activity, which may alert us to further investigation requirements.


Depression;  Physical exercise;  Fatigue;  Malignant hyperthermia
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Braz J Anesthesiol

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