Malignant hyperthermia during laparoscopic adjustable gastric banding.
BACKGROUND
We report a rare case of malignant hyperthermia during laparoscopic adjustable gastric banding.


METHODS
A 32-y-old female with no previous history of adverse reaction to general anesthesia underwent laparoscopic adjustable gastric banding. Intraoperative monitoring revealed a sharp increase in end-tidal carbon dioxide, autonomic instability, and metabolic and respiratory acidosis, along with other metabolic and biochemical derangements. She was diagnosed with malignant hyperthermia. Desflurane, the anesthetic agent was discontinued, and the patient was started on intravenous dantrolene.


RESULTS
The surgery was completed, and the patient was brought to the surgical intensive care unit for continued postoperative care. She developed muscle weakness and phlebitis that resolved prior to discharge.


CONCLUSIONS
Prompt diagnosis and treatment of malignant hyperthermia leads to favorable clinical outcome. This clinical entity can occur in the bariatric population with the widely used desflurane. Bariatric surgeons and anesthesiologists alike must be aware of the early clinical signs of this rare, yet potentially fatal, complication.
Department of Surgery, NY Methodist Hospital, Brooklyn, NY, USA.
Josue
J
Chery
Chiba
C
Shintaro
Ambibola
A
Pratt
Ronell
R
Kirkley
Barbara
B
Hearne
Andrew
A
Beyzman
Piotr
P
Gorecki
D000328:Adult; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D015897:Comorbidity; D000077335:Desflurane; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives; D010535:Laparoscopy / Q000009:adverse effects*; D008305:Malignant Hyperthermia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery
D018685:Anesthetics, Inhalation; D000077335:Desflurane; D007530:Isoflurane