[Propofol triggers a marked body temperature increase in a patient with fulminant malignant hyperthermia (MH) without inducing other symptoms of MH].
A 53-year-old woman who had experienced symptoms of fulminant malignant hyperthermia (MH) by sevoflurane a week before and her MH muscle biopsy revealing positive later, underwent the right hemicolectomy under total intravenous anesthesia with propofol and fentanyl. The patient's body temperature increased at a rate of 0.6 degree C per 15 min from 37.5 to 39.4 degrees C, but other symptoms of MH, such as tachycardia, arrhythmia, acidemia, and hypoxemia, were obviously slight in comparison with those induced by sevoflurane. The body temperature decreased after discontinuation of propofol and administration of dantrorene injection. When the patient received continuous propofol infusion for the purpose of sedation in the intensive care unit again, the body temperature gradually increased to 40 degrees C. However, it decreased to 37.8 degrees C after discontinuation of propofol and dantrorene injection again. It is well recognized that propofol is not a MH trigger, but it shoud be noted that some MH patients could experience a hypermetabolic state, such as hyperthermia, even by propofol.
Murao
Kohei
K
Department of Anesthesiology, Saiseikai Ibaraki Hospital, Ibaraki.
Umegaki
Takeshi
T
Masuzawa
Munehiro
M
Inoue
Shoko
S
Nakao
Shinichi
S
Shingu
Koh
K
D000771:Anesthesia, Intravenous / Q000009:adverse effects*; D019162:Anesthetics, Combined / Q000009:adverse effects*; D001831:Body Temperature; D003082:Colectomy; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D008305:Malignant Hyperthermia / Q000209:etiology* / Q000503:physiopathology; D008738:Methyl Ethers / Q000009:adverse effects; D008875:Middle Aged; D015742:Propofol / Q000009:adverse effects*; D000077149:Sevoflurane
D019162:Anesthetics, Combined; D008738:Methyl Ethers; D000077149:Sevoflurane; D005283:Fentanyl; D015742:Propofol