Suspected malignant hyperthermia during sevoflurane anesthesia.
Malignant hyperthermia is a rare anesthetic-related disorder. We present a case with unusual presentation. A boy aged 3 years and 9 months who was scheduled for Hotz's operation presented normally before the operation. Anesthesia was induced by atropine, thiopental and sevoflurane. Trachea intubation was facilitated by succinylcholine. Jaw stiffness was first noted although trachea was intubated without difficulty. The following tachycardia, hypercapnia and hyperthermia led to the diagnosis of malignant hyperthermia. Symptoms were relieved dramatically after the discontinuation of sevoflurane. Molecular genetic testing identified a novel ryanodine receptor (RYR1) mutation in exon 39, which confirmed malignant hyperthermia susceptibility in this patient.
Department of Anesthesiology, Changhua Christian Hospital, Changhua City, Changhua County 500, Taiwan, ROC.
Shu-Chia
SC
Hsu
Wei-Tai
WT
Huang
Huei-Ming
HM
Yeh
Allen Yi-Jer
AY
Hsieh
D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002675:Child, Preschool; D006801:Humans; D008297:Male; D008305:Malignant Hyperthermia / Q000209:etiology* / Q000235:genetics; D008738:Methyl Ethers / Q000009:adverse effects*; D009154:Mutation; D019837:Ryanodine Receptor Calcium Release Channel / Q000235:genetics; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D019837:Ryanodine Receptor Calcium Release Channel; D000077149:Sevoflurane