[Delayed onset of malignant hyperthermia crisis during a living donor liver transplantation caused by sevoflurane].
We report on a 25-year old ASA physical status I patient, who developed within 20 minutes a full-blown malignant hyperthermia (MH) in the context of a living donor liver transplantation after 180 minutes of uneventful anaesthesia. The only trigger substance applied was Sevoflurane. The patient had already received a short, uneventful anaesthesia with Isoflurane a couple of years ago. In the context of the special constellation an initial dose of Dantrolene of 10 mg/kg body weight was administered. The patient was stabilised within 30 minutes, and the enzyme levels remained low compared with other case reports. The post-operative in vitro caffeine halothane contracture testing confirmed that son and mother were susceptible to MH, contracture testing in the father was negative. All known triggers may cause life-threatening MH crisis - even after hours and after inconspicuous multiple exposures to known trigger substances. Therefore all trigger substances must be avoided in all patients susceptible to MH.
Gillmeister
I
I
Klinik für Anästhesie und Intensivtherapie, Friedrich-Schiller Universität Jena.
Schummer
C
C
Hommann
M
M
Schummer
W
W
D000328:Adult; D000769:Anesthesia, Inhalation / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D001784:Blood Gas Analysis; D002110:Caffeine; D000697:Central Nervous System Stimulants; D006221:Halothane; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008305:Malignant Hyperthermia / Q000209:etiology* / Q000503:physiopathology; D008738:Methyl Ethers / Q000009:adverse effects*; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D000697:Central Nervous System Stimulants; D008738:Methyl Ethers; D000077149:Sevoflurane; D002110:Caffeine; D006221:Halothane