title: [Difficult tracheal intubation in a patient suspected of malignant hyperthermia].
abstract: We report anesthetic management of a patient suspected of malignant hyperthermia with difficult tracheal intubation. A 64-year-old man was scheduled for a fixation of humerus bone fractures in prone position. He had a history of difficult tracheal intubation due to masseter spasm, and his niece was suspected to be malignant hyperthermia. Anesthesia was induced with propofol using a target controlled infusion. No muscle relaxant was given and spontaneous breathing was maintained. Trials for tracheal intubation failed whenever using a standard laryngoscope, a bronchofiberscope, a laryngeal mask airway or an intubating laryngeal mask airway. Resecting the epiglottic elevating bar of an intubating laryngeal mask airway enabled fiberoptic tracheal intubation. No symptom suggesting malignant hyperthermia developed.
authors.affiliation: Department of Anesthesiology, Kansai Medical University, Moriguchi 570-8506.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nikaido
authors.forename: Kohei
authors.initials: K
authors.lastname: Murao
authors.forename: Sakahiro
authors.initials: S
authors.lastname: Ikeda
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Yuka
authors.initials: Y
authors.lastname: Uchiyama
authors.forename: Koh
authors.initials: K
authors.lastname: Shingu
mesh_terms: D000758:Anesthesia / Q000379:methods*; D018686:Anesthetics, Intravenous; D005283:Fentanyl; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D008297:Male; D008305:Malignant Hyperthermia; D008875:Middle Aged; D015742:Propofol
chemical_list: D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol