[Malignant hyperthermia during the 13th general anaesthesia (author's transl)]

Area of Science:

• Anesthesiology
• Pharmacology
• Genetics

Background:

• Malignant hyperthermia (MH) is a rare, life-threatening pharmacogenetic disorder of skeletal muscle.
• It is typically triggered by volatile anesthetics and succinylcholine.
• Genetic predisposition and family history are significant risk factors.

Observation:

• A 41-year-old male developed MH during his 13th general anesthesia.
• Previous anesthetics in this patient were uneventful.
• Family members exhibited musculoskeletal abnormalities and elevated creatine phosphokinase (CPK) levels.

Findings:

• The combined administration of suxamethonium and halothane is implicated as the potential trigger for MH in this case.
• The patient's family history of musculoskeletal issues and elevated CPK suggests a possible genetic susceptibility.
• The case history points towards a stress-related etiology for the development of MH.

Implications:

• This case highlights the unpredictable nature of MH, even in patients with a history of uneventful anesthesia.
• It underscores the importance of considering genetic predisposition and potential environmental triggers like stress in MH susceptibility.
• Further research into stress-induced mechanisms of MH could refine diagnostic and management strategies.