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Malignant hyperthermia suggestive hypermetabolic syndrome at emergence from anesthesia

par Christiaens, Frank;Gepts, Elisabeth;D'Haese, Jan;Camu, Frédéric
Référence Acta Anaesthesiologica Belgica, 46, 2, page (93-97)
Publication Publié, 1995

Article révisé par les pairs

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Résumé :

A 6-year old female child received succinylcholine (1 mg.kg-1) and isoflurane (concentrations of 1.5-2 percent) and developed at the end of surgery a hypermetabolic syndrome suggestive of malignant hyperthermia (MH) with masseter muscle spasm, muscle rigidity, tachypnea, systolic hypertension (140 mmHg), tachycardia (205 beats.min-1), hypercarbia (end expiratory CO2 71 mmHg), and an increase in body temperature (39.2°C). The child responded well to therapy which included cooling, hyperventilation with pure oxygen and dantrolene administration. However, blood creatine kinase and myoglobin elevations were moderate (respectively 375 IU.L-1 and 114 μg.L-1) and an in vitro halothane and caffeine contracture test was negative. Differential diagnostic proposals are discussed and compared to the clinical incident.