Korean J Anesthesiol.  1993 Apr;26(2):341-346. 10.4097/kjae.1993.26.2.341.

Two Cases of Generalized Muscular Rigidity, Hyperpyrexia, Unconsciousness and Autonomic Dysfunction after Spinal Anesthesia

• Kim YC
• Kim TH
• Chung SL

• KMID: 2239266
• DOI: http://doi.org/10.4097/kjae.1993.26.2.341

Abstract

Malignant hyperthermia is a fulminant hypermetabolic state of skeletal muscle induced by volatile inhalation anesthetics, succinylcholine, stress, exercise and etc. The primary signs of this disease included tachycardia, tachypnea, fever, generalized rigidity, metabolic and respiratory acidosis, central venous desaturation and hypercarbia as well as increasing endtidal CO2. Malignant hyperthermia is an utosomal dominant trait in human and quite different from the recessive trait in pig. There were some clinical reports that malignant hyperthermia can occur occasionally during and after spinal anesthesia. Now we also experienced two cases of generalized muscular rigidity, hyperpyrexia, tachycardia, hypotension, cardiae arrhythmia and slightly metabolic acidosis during and after spinal anesthesia. Those signs were very similar to malignant hyperthermia. And the two patients and someone among the family showed increased serum creatine kinase. There was no serum electrolyte imbalance such as natrium, ionized calcium and magnesium. And function tests of thyroid and parathyroid, electroencephalogram and brain computed tomogram were all within normal limit. So we suspected and concluded that it should be malignant hyperthermia. But we could not confirm that malignant hyperthermia, because of not doing halothane caffeine contracture test due to a lack of equipment in our hospital.

Keyword

Spinal anesthesia; Malignant hyperthermia

MeSH Terms

Acidosis
Acidosis, Respiratory
Anesthesia, Spinal*
Anesthetics, Inhalation
Arrhythmias, Cardiac
Brain
Caffeine
Calcium
Cardia
Contracture
Creatine Kinase
Electroencephalography
Fever
Halothane
Humans
Hypotension
Magnesium
Malignant Hyperthermia
Muscle Rigidity*
Muscle, Skeletal
Succinylcholine
Tachycardia
Tachypnea
Thyroid Gland
Unconsciousness*
Anesthetics, Inhalation
Caffeine
Calcium
Creatine Kinase
Halothane
Magnesium
Succinylcholine