Korean J Anesthesiol.  1988 Aug;21(4):674-678. 10.4097/kjae.1988.21.4.674.

Anesthesia for Thymectomy in Patient with Myasthenia Gravis - Two cases report

• Kim YG
• Kim HY
• Lee DK

• KMID: 1933143
• DOI: http://doi.org/10.4097/kjae.1988.21.4.674

Abstract

Malignant hyperthermia is an inherited disorder of skeletal muscle, characterized by temperature elevation, muscle destruction, muscle rigidity and high oxygen consumption, etc. It is triggered by anesthetic agents, usually potent inhalation anesthetics and succinylcholine. It is fatal in the majority of cases unless early diagnosis andtreatment are performed. We experienced a case of malignant hyperthermia after general anesthesia with succinylcholine and halothane. The case is presented of an 11 year old male weighing 35.5kg. He had developed the strabismus one year prior, but he was relatively healthy and had no considerable past or family history. He underwent surgery for correction of the strabismus under N2O-O2-halothane anesthesia with induction by thiopental and succinycholine. Approximtely 25 minutes after induction tachycardia developed, followed by severe arrhythmia with unstable BP, temperature elevation and cyanosis. About 30 minutes after induction, anesthesia was stopped and aggressive emergency management was performed. Unfortunately, the patient died 4 hours and 30 minutes after induction. We discuss this case and review the history, incidence, etiology, pathophysiology, symptoms, diagnosis, pervention and treatment.

Keyword

Malignant hyperthermia; Skeletal muscle; Temperature

MeSH Terms

Anesthesia*
Anesthesia, General
Anesthetics
Anesthetics, Inhalation
Arrhythmias, Cardiac
Child
Cyanosis
Diagnosis
Early Diagnosis
Emergencies
Halothane
Humans
Incidence
Male
Malignant Hyperthermia
Muscle Rigidity
Muscle, Skeletal
Myasthenia Gravis*
Oxygen Consumption
Strabismus
Succinylcholine
Tachycardia
Thiopental
Thymectomy*
Anesthetics
Anesthetics, Inhalation
Halothane
Succinylcholine
Thiopental