Suspected malignant hyperthermia in a 13-month-old: today's "typical" episode--a case report

A case of suspected malignant hyperthermia in a 13-month-old female, to whom succinylcholine was not administered, is presented. The patient presented for a repair of the right radial nerve under general anesthesia. Induction was accomplished with halothane, nitrous oxide, and oxygen. Tracheal intubation was facilitated with intravenous vecuronium. Controlled ventilation was initiated, and anesthesia was maintained with isoflurane, nitrous oxide, oxygen, morphine sulfate, and vecuronium. At the conclusion of the surgical procedure, an abrupt increase in ETCO2, an elevation in body temperature, and a mixed acidosis was observed. Resolution of symptoms followed the administration of dantrolene sodium. The patient underwent an uneventful postoperative recovery and was discharged home. It was felt that the patient was too young to undergo a muscle biopsy for a caffeine-halothane stimulation test.