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Post-Operative Malignant Hyperthermia in a Child after Colon Interposition.
Sevtap Hekimoğlu Şahin1, Mustafa İnan2, Burhan Aksu2
1Department of Anaesthesiology and Reanimation, Trakya University Faculty of Medicine, Edirne, Turkey.
Turkish Journal of Anaesthesiology and Reanimation
|July 2, 2016
Summary
Malignant hyperthermia (MH), a rare anesthesia complication, occurred late in a 2-year-old boy after esophageal replacement surgery. Despite dantrolene treatment, the patient experienced fatal cardiopulmonary arrest, highlighting post-operative MH risks.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Critical Care Medicine
Background:
- Malignant hyperthermia (MH) is a rare, life-threatening pharmacogenetic disorder of skeletal muscle.
- It is a known complication of volatile anesthetic agents and succinylcholine.
- Late-onset MH, particularly post-operatively, is less common but remains a critical concern.
Observation:
- A 2-year-old boy underwent colon interposition for esophageal replacement under sevoflurane anesthesia.
- The patient developed late-onset malignant hyperthermia post-operatively.
- Initial treatment included intravenous dantrolene sodium, cooling, and controlled ventilation.
Findings:
- Despite aggressive management, the patient progressed to cardiopulmonary arrest 21 hours after surgery.
- The case demonstrates a fatal outcome in a pediatric patient with late-onset MH.
- Ischemia-reperfusion injury associated with major surgery may be a contributing factor.
Implications:
- This case underscores the importance of recognizing and managing post-operative malignant hyperthermia, even in late-onset presentations.
- Surgeons and anesthesiologists should consider the potential for MH in patients undergoing extensive procedures with potential for ischemia-reperfusion.
- Vigilance and prompt treatment are crucial for improving outcomes in malignant hyperthermia events.
