Malignant hyperthermia during a laparoscopic operation

Malignant hyperthermia (MH) is a life-threatening complication of general anesthesia, and early diagnosis and prompt treatment are important for successful management of this condition. Diagnosis of MH during a laparoscopic operation may be difficult because the early signs of the condition are similar to the expected physical changes that occur during laparoscopy. Herein is presented the case of a successfully treated 37-year-old woman without any pertinent surgical or medical history in whom MH developed during laparoscopic myomectomy. The operation was initiated with the patient under general anesthesia with propofol, sevoflurane, nitrous oxide, and intermittent doses of vecuronium. Twenty minutes after the start of CO(2) insufflation, increased end-tidal CO(2) and tachycardia were observed, which did not improve even with increased ventilation and release of insufflation. The anesthesiologist strongly suspected MH, and dantrolene was immediately administered. The patient quickly recovered, and experienced no postoperative complications.