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A suspected case of anesthesia-induced rhabdomyolysis in a child undergoing strabismus surgery

Anne-Marie Leo1, Mark J McVey2, Megumi Iizuka3

  • 1Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|February 9, 2019
PubMed

Insights

A previously healthy girl developed acute rhabdomyolysis after anesthesia for strabismus surgery. This rare complication, anesthesia-induced rhabdomyolysis (AIR), can occur with certain anesthetic drugs.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Neuromuscular Disorders

Background:

  • General anesthesia for strabismus surgery involves specific anesthetic agents.
  • Certain anesthetic drugs, including succinylcholine and sevoflurane, carry rare risks.
  • Anesthesia-induced rhabdomyolysis (AIR) and malignant hyperthermia (MH) are potential complications.

Observation:

  • An 11-year-old girl, previously healthy, underwent strabismus surgery under general anesthesia.
  • The anesthetic regimen included a depolarizing muscle relaxant (succinylcholine) and a halogenated volatile anesthetic (sevoflurane).
  • The patient subsequently developed acute rhabdomyolysis.

Findings:

  • The case highlights a rare instance of anesthesia-induced rhabdomyolysis (AIR).
  • Succinylcholine and sevoflurane are implicated as potential triggers for AIR.
  • Prompt recognition and management are crucial for preventing severe outcomes.

Implications:

  • Awareness of AIR is critical for anesthesiologists and surgeons performing strabismus surgery.
  • Early diagnosis and intervention can mitigate the significant morbidity and mortality associated with AIR.
  • Further research into risk factors and preventative strategies for AIR in pediatric patients is warranted.

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