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Malignant hyperthermia during laparoscopic adjustable gastric banding.
Josue Chery1, Chiba Shintaro, Ambibola Pratt
1Department of Surgery, NY Methodist Hospital, Brooklyn, NY, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|August 9, 2013
Summary
Malignant hyperthermia is a rare but serious complication that can occur during laparoscopic adjustable gastric banding. Prompt diagnosis and dantrolene treatment led to a favorable outcome in this bariatric surgery patient.
Area of Science:
- Anesthesiology
- Bariatric Surgery
- Pharmacology
Background:
- Malignant hyperthermia is a rare, life-threatening pharmacogenetic disorder of skeletal muscle.
- Laparoscopic adjustable gastric banding is a common bariatric procedure.
- The potential for malignant hyperthermia in bariatric patients requires careful anesthetic management.
Observation:
- A 32-year-old female developed malignant hyperthermia during laparoscopic adjustable gastric banding.
- Intraoperative signs included increased end-tidal carbon dioxide, autonomic instability, and acidosis.
- The patient received desflurane, a volatile anesthetic agent.
Findings:
- Diagnosis of malignant hyperthermia was confirmed by clinical presentation.
- Discontinuation of desflurane and administration of intravenous dantrolene were initiated.
- Postoperative recovery included muscle weakness and phlebitis, which resolved before discharge.
Implications:
- Early recognition and prompt treatment of malignant hyperthermia are crucial for favorable outcomes.
- Desflurane can trigger malignant hyperthermia in susceptible individuals within the bariatric population.
- Anesthesiologists and bariatric surgeons must be vigilant for malignant hyperthermia signs during surgery.
