A case report of malignant hyperthermia in a dental clinic operating room.
A healthy 5-year-old boy presented for arch bar placement under general anesthesia in an operating room in a dental school. The patient had previously undergone general anesthesia without complication, and no family history of anesthetic problems were reported. Halothane mask induction, intravenous catheter placement, and nasal intubation proceeded uneventfully without the aid of a muscle relaxant. Halfway through the procedure, signs and symptoms of malignant hyperthermia, including muscle rigidity, hypercarbia, tachypnea, and tachycardia were noted. Immediate treatment, including discontinuation of the triggering agent, dantrolene administration, and cooling measures were applied, and once stable, the child was transferred to Columbus Children's Hospital for further management. The patient experienced no postoperative complications. Further discussion regarding the pathophysiology and management of malignant hyperthermia is provided.
Fukami
M Cynthia
MC
Department of Dentistry, Columbus Children's Hospital, Columbus, OH 43205, USA. fukamic@chi.osu.edu
Ganzberg
Steven I
SI
D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002675:Child, Preschool; D003620:Dantrolene / Q000627:therapeutic use; D005500:Follow-Up Studies; D006221:Halothane / Q000009:adverse effects*; D006801:Humans; D019248:Jaw Fixation Techniques / Q000295:instrumentation; D008297:Male; D008305:Malignant Hyperthermia / Q000209:etiology*; D008335:Mandibular Condyle / Q000293:injuries; D008337:Mandibular Fractures / Q000601:surgery; D009125:Muscle Relaxants, Central / Q000627:therapeutic use
D018685:Anesthetics, Inhalation; D009125:Muscle Relaxants, Central; D003620:Dantrolene; D006221:Halothane