[Fulminant malignant hyperthermia during the 6th general anesthesia using volatile anesthetics].
We report on the fulminant crisis of malignant hyperthermia occurring in a 30-year-old female during kidney transplantation. In the past, she had been anaesthetised repeatedly without complications. Anaesthesia was induced with thiopental and vecuronium and continued with isoflurane/N2O/O2. After an initially normal course of anaesthesia, the patient developed symptoms of a fulminant malignant hyperthermia (MH) including excessive increase in end expiratory CO2, hyperkalaemia, tachycardia and hyperpyrexia. The patient was saved by the timely administration of dantrolene. A surgical revision required the next day because of bleeding was done under dantrolene cover and took an uncomplicated course. The patient was extubated 7.5 hours after the second intervention and transferred to a normal ward after 4 days. A subsequently performed in vitro contracture test clearly revealed susceptibility to malignant hyperthermia.
Striebel
H W
HW
Klinik für Anästhesiologie und operative Intensivmedizin, Klinikum Steglitz, Freie Universität Berlin.
Lechner
J
J
Wiegand
C
C
Hartung
E
E
D000328:Adult; D000769:Anesthesia, Inhalation / Q000009:adverse effects*; D003620:Dantrolene / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007530:Isoflurane; D016030:Kidney Transplantation; D008305:Malignant Hyperthermia / Q000188:drug therapy / Q000209:etiology*; D009609:Nitrous Oxide; D010100:Oxygen
D007530:Isoflurane; D003620:Dantrolene; D009609:Nitrous Oxide; D010100:Oxygen
Fulminante maligne Hyperthermie während der sechsten Vollnarkose mit volatilen Anästhetika.