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Malignant hyperthermia and the conscious patient
1Dandenong and District Hospital, Victoria, Australia.
Summary
A patient with appendicitis and a family history of malignant hyperthermia experienced a malignant hyperthermia episode during surgery. Early administration of dantrolene sodium successfully treated the malignant hyperthermia attack.
Area of Science:
- Anesthesiology
- Genetics
- Surgical Oncology
Background:
- Malignant hyperthermia (MH) is a rare, life-threatening pharmacogenetic disorder of skeletal muscle.
- Patients with a family history of MH trait require careful anesthetic management.
- Obesity can increase anesthetic risks and complicate surgical procedures.
Observation:
- A 53-year-old obese male presented with acute appendicitis.
- He had a family history suggestive of malignant hyperthermia trait.
- Despite spinal anesthesia, the patient developed malignant hyperthermia during appendectomy.
Findings:
- The patient experienced a malignant hyperthermia crisis during the surgical procedure.
- Early intervention with dantrolene sodium was administered.
- The malignant hyperthermia attack was successfully aborted.
Implications:
- This case highlights the importance of recognizing MH risk factors, even with regional anesthesia.
- Prompt recognition and treatment with dantrolene are crucial for successful MH management.
- Anesthesiologists and surgeons must be prepared for MH events in susceptible patients.