A case of malignant hyperthermia

Abstract

A 10-year-old boy without any abnormal laboratory finding or abnormal family history underwent surgical operation for undescending testicle. He was anesthetized with general anesthesia (sevoflurane and nitrous oxide in oxygen) and caudal block using mepivacaine. Ninety minutes after the induction of anesthesia, malignant hyperthermia was suspected because of the recognition of abnormal findings such as abnormal increase of rectal temperature, leakage of endotracheal tube, and muscle rigidity of jaw and upper extremities. Maximum body temperature was noted to be 39.9°C, 93 mmHg of ETCO2 and 92 mmHg of PaCO2. By the general cooling and i.v. administration of dantrolene, these abnormal findings were restored to the normal values. The patient was discharged uneventfully. The abnormal acceleration of Ca-induced Ca release rate of his skeletal muscle using skinned fiber technique was confirmed.