Sevoflurane-induced malignant hyperthermia during cardiopulmonary bypass and moderate hypothermia.
A 56-year old man was admitted for elective mitral valve repair and coronary artery bypass surgery due to mitral valve leakage and unstable angina. After induction of anaesthesia he developed a combined metabolic and respiratory acidosis. Different diagnosis were considered and we decided to treat the patient with dantrolene due to suspicion of malignant hyperthermia (MH). The patient received one dose of dantrolene 2,5 mg/kg during cardiopulmonary bypass (CPB) and a second dose of dantrolene 2,5 mg/kg during weaning from CPB. The first arterial blood gas sample taken in the intensive care unit showed relapse of the acidosis and we administered an infusion of 150 mg dantrolene over 3 hours. The patient gradually recovered without sequel and MH was verified by muscle biopsy testing.
Department of Anaesthesia, Section for Cardiothoracic Anaesthesia, Ulleval University Hospital, Oslo, Norway. alfarne.jonassen@uus.no
A A
AA
Jonassen
A J
AJ
Petersen
S
S
Mohr
C
C
Andersson
J
J
Skattum
K
K
Kvernebo
O G
OG
Paulsen
O
O
Stokland
K A
KA
Kirkebøen
D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D000787:Angina Pectoris / Q000601:surgery; D001784:Blood Gas Analysis; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003620:Dantrolene / Q000627:therapeutic use; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007036:Hypothermia, Induced; D008297:Male; D008305:Malignant Hyperthermia / Q000503:physiopathology*; D008738:Methyl Ethers / Q000009:adverse effects*; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D009125:Muscle Relaxants, Central; D000077149:Sevoflurane; D003620:Dantrolene