[Atypical course of malignant hyperthermia]

A 40 year old man, who was suspected on clinical evidence (fever, severe muscle pains, dark urine following general anesthesia 8 years ago) of being susceptible to malignant hyperthermia, was scheduled for traumatologic surgery. Dantrolene-Sodium 4 mg/kg orally was given prophylactically the day before surgery; as a premedication the patient received morphine and triflupromazine intramuscularly. Anesthesia was induced with flunitrazepam and fentanyl, pancuronium bromide was administered for endotracheal intubation and neuromuscular blockade during surgery. No complications were seen during anaesthesia and the following immediate postoperative period. 10 hrs after surgery an episode of pyrexia lasting about 20 h and an elevation of blood creatine phosphokinase (CPK) has been noted. The remainder of the postoperative course was uneventful. The patient was discharged 9 days later.