Abstract

Malignant hyperthermia (MH) is a rare pharmacogenetic syndrome, which is characterized as a severe hypermetabolic reaction followed by halogenated inhalational anesthetic administration and/or depolarizing muscle relaxants, such as succinylcholine. Therefore, patients at risk of MH need trigger-free anesthesia in order to avoid life-threatening metabolic crises. This report discusses a case of MH in a six-year-old patient, during an Orchidopexy and Urethrocutaneous Fistul’s Correction under general anesthesia.
Inhalational induction was carried out using Sevoflurane, whereas propofol and fentanyl were afterward administered. During the procedure, the patient developed hypercapnia, significant temperature rise, masseter rigidity, and hyperkalemia. With a diagnostic hypothesis of MH, a protocol guided by the Hotline for MH was applied, leading to a great patient response that made it possible to transfer the child to the Pediatric Intensive Care Unit where dantrolene was administered, allowing good control of the patient’s general condition.

Keywords

Malignant hyperthermia, Pediatric anesthesia, Patient Safety, Trigger-free anesthesia, Case report