Related Experiment Video
Updated: Jun 28, 2026
06:43
Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Malignant hyperthermia developing during esophageal resection in an 82-year-old man
Norihito Nakamura1, Tomomi Ueda, Reiri Ishikawa
1Department of Anesthesiology, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan.
Journal of Anesthesia
|November 18, 2008
Summary
Malignant hyperthermia (MH), a rare anesthesia complication, occurred in an 82-year-old patient. Early recognition of hypercapnia and hyperthermia is crucial for prompt dantrolene treatment, even in the elderly.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Malignant hyperthermia (MH) is a rare, life-threatening complication of general anesthesia.
- Elderly patients (over 80) are infrequently reported to develop MH.
Observation:
- An 82-year-old patient undergoing esophageal resection developed MH during sevoflurane anesthesia.
- Initial symptoms included unexplained hypercapnia, followed by rapid, severe hyperthermia exceeding 39.0°C.
- Masseter spasm and limb rigidity were absent during induction.
Findings:
- Prompt administration of dantrolene successfully reduced the patient's body temperature from a maximum of 40.9°C to 37.7°C.
- Continuous dantrolene infusion in the ICU prevented recurrence, allowing for successful re-operation the following day.
Implications:
- This case highlights the importance of suspecting MH in elderly patients presenting with hypercapnia and hyperthermia under anesthesia.
- Early diagnosis and immediate dantrolene treatment are critical for managing MH, regardless of patient age.
- Anesthesiologists should maintain a high index of suspicion for MH in older adults, despite its low prevalence.
Related Concept Videos
01:25Increased Body Temperature
A body temperature above 38°C (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in response to an infection or illness.
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
01:30Esophageal Strictures-I: Introduction
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
01:27Esophageal Achalasia
Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
01:22Esophageal Perforation-I: Introduction
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
01:21Barrett Esophagus-II: Clinical Manifestations and Management
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...