Elimination of hypercapnia may postpone the clinical presentation of malignant hyperthermia: a case report

Malignant hyperthermia is a rare complication in clinical anesthesia, especially associated with the administration of succinylcholine or inhalation anesthetics. A 19-year-old patient, suffering from traumatic mandible fracture, underwent open reduction under general anesthesia. Unfortunately, following administration of succinylcholine, he also suffered severe facial twitch and the first episode of hypercapnia. After adequate management, the symptoms subsided. However, two hours later, the hypercapnia recurred, combined with progressive elevation of body temperature. After administration of intravenous dantrolene 120 mg, the patient's condition became stable and the procedure was completed without sequelae. As the muscle contracture test is not available in Taiwan, the clinical grading scale is presented as an alternative diagnostic method for malignant hyperthermia.