Repeat episodes of severe muscle rigidity in a child receiving sevoflurane.
We report on a patient who developed two episodes of severe muscle rigidity, increased endtidal CO2 and increased creatine phosphate kinase associated with sevoflurane anesthesia. Dysrhythmias and hyperthermia were not observed and dantrolene was not administered. Genetic testing for the 17 known mutations associated with malignant hyperthermia (MH) was negative. Although we cannot rule out MH or other neuromuscular diseases we suggest that this rare event may be a direct effect of sevoflurane.
Cohen
Ira Todd
IT
Department of Anesthesiology, Children's National Medical Center, Washington, DC 20010, USA. icohen@cnmc.org
Kaplan
Richard
R
D000015:Abnormalities, Multiple / Q000503:physiopathology; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000503:physiopathology; D002245:Carbon Dioxide / Q000378:metabolism; D003402:Creatine Kinase / Q000378:metabolism; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000503:physiopathology; D005334:Fever / Q000139:chemically induced / Q000503:physiopathology; D006801:Humans; D008297:Male; D008305:Malignant Hyperthermia / Q000175:diagnosis / Q000235:genetics; D008738:Methyl Ethers / Q000009:adverse effects*; D009127:Muscle Rigidity / Q000139:chemically induced*; D009154:Mutation; D011247:Pregnancy; D012008:Recurrence; D000077149:Sevoflurane; D019966:Substance-Related Disorders / Q000150:complications / Q000503:physiopathology
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D002245:Carbon Dioxide; D000077149:Sevoflurane; D003402:Creatine Kinase