Malignant Hyperthermia During General Anesthesia: A case report / 대한마취과학회지

ABSTRACT

Malignant hyperthermia is defined as a potentially fatal hypermetabolic syndrome characterized by hyperpyrexia, skeletal muscle rigidity, tachycardia, respiratory and metabolic acidosis, cyanosis etc. Any inhalation anesthetic agent or any skeletal muscle relaxant can trigger this acute catastrophic reaction. This case is presented of a 37 year old female patient in whom total gastrectomy was planed to perform under oxygen-nitrous oxide-isoflurane anesthesia with induction by thiopental sodium and succinylcholine. When administer of succinylcholine to induction, the jaw was very tight and the mouth was impossible to open. We retried with vecuronium and the jaw was slightly resistant to opening, but intubation was successfully performed. After induction, hyperpyrexia, tachycardia, increased end-tidal carbon dioxide developed. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated successfully with early detection and intensive care. According to decrease of temperature and normalization of arterial blood gas, the procedure continued with nontriggering agent, fentanyl. The etiologic factors, clinical features, treatment and preventive measures of malignant hyperthermia are discussed.