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Malignant hyperthermia presenting during laparoscopic adrenalectomy
Author(s) -
O'Neill S. S.,
Smurthwaite G. J.
Publication year - 2008
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05405.x
Subject(s) - medicine , malignant hyperthermia , dantrolene , hyperthermia , laparoscopic surgery , anesthesia , pneumoperitoneum , surgery , contracture , laparoscopy , calcium
Summary A 44‐year‐old man presented for elective laparoscopic adrenalectomy. During the procedure his end‐tidal carbon dioxide readings rose steadily. We assumed that this was due to a prolonged carbon dioxide pneumoperitoneum until he developed ST segment depression on his electrocardiogram and a rapid rise in temperature. A diagnosis of malignant hyperthermia was made in view of the rising temperature and carbon dioxide. He responded to cooling and intravenous dantrolene. He was later confirmed to be malignant hyperthermia‐susceptible on in vitro contracture testing of a muscle biopsy. The diagnosis was delayed as the early signs of malignant hyperthermia are the same as the expected physiological changes in laparoscopic surgery. As laparoscopic surgery continues to expand we advocate vigilance to ensure early identification of this rare but potentially devastating condition.