Desflurane, malignant hyperthermia, and release of compartment syndrome.
We describe a case of suspected malignant hyperthermia in a healthy 20-yr-old man. The patient underwent urgent release of upper extremity compartment syndrome as a result of traumatic vascular injury. After 3 h of general anesthesia with desflurane, he developed a hypermetabolic state (hypercarbia, hyperthermia, hyperkalemia, and metabolic acidosis), consistent with the diagnosis of malignant hyperthermia. Cardiovascular instability coincided with reperfusion of the injured extremity. Treatment with dantrolene and supporting measures restored cardiovascular stability. Three days later he underwent a successful second surgery under regional block with total IV anesthesia.
Uskova
Anna A
AA
Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Matusic
Bryan P
BP
Brandom
Barbara W
BW
D000328:Adult; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002245:Carbon Dioxide / Q000097:blood; D003161:Compartment Syndromes / Q000628:therapy*; D000077335:Desflurane; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects* / Q000031:analogs & derivatives*; D008297:Male; D008305:Malignant Hyperthermia / Q000209:etiology* / Q000628:therapy
D018685:Anesthetics, Inhalation; D002245:Carbon Dioxide; D000077335:Desflurane; D007530:Isoflurane