| Anesthesia for Thymectomy in Patient with Myasthenia Gravis - Two cases report. |
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Young Gyou Kim, Hong Youl Kim, Dong Ki Lee |
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Department of Anesthesiology, Seoul Red Cross Hospital, Seoul, Korea. |
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| Abstract |
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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. |
| Key Words:
Malignant hyperthermia; Skeletal muscle; Temperature |
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