Malignant Hyperthermia in a Patient with Partially Accommodative Esotropia

ABSTRACT

PURPOSE: Malignant hyperthermia is hypermetabolic disorder of skeletal muscle that manifests during general anesthesia. Strabismus and ptosis are important risk factors in ophthalmology field for malignant hyperthermia. We report a case of malignant hyperthermia in patient with partially accommodative esotropia. CASE SUMMARY: A 6-year-old patient was supposed to undergo a surgical correction for 20 prism diopters of right esotropia after correction of hypermetropia. Because the patient showed tachycardia and hyperthermia just after inhalation of sevoflurane, we interrupted general anesthesia and cancelled the surgery. The patient was transferred to the intensive care unit. In this case, no significant familial and past histories were found. Intractable tachycardia and hyperthermia that had not responded to conservative management improved after two administration of dantrolene sodium. The patient was returned to the ward three days later. As the patient showed no other complication, he was discharged. CONCLUSIONS: In malignant hyperthermia, early diagnosis, appropriate management, and prompt administration of dantrolene sodium are important factors for better prognosis. Preoperatively, full explanation of possible complication and history taking are needed. Careful observation is necessary during anesthesia and surgery.