Pathologic Findings in Malignant Hyperthermia and Treatment: A Case Report.

Abstract

Malignant hyperthermia is a pharmacogenetic disorder of skeletal muscle that manifests as a hypermetabolic response to potent volatile anesthetic gases, including halothane, sevoflurane, desflurane, isoflurane, and depolarizing muscle relaxants such as succinylcholine, and occurs in humans in response to stressors such as strenuous exercise and heat. A 44-year-old male patient with a body weight of 100 kg, scheduled for rhinoplasty surgery at the ENT (Ear, Nose, and Throat) clinic with no history of anesthesia-related complications, was anesthetized with propofol, fentanyl, and rocuronium induction following preoperative evaluation. Maintenance anesthesia was provided with sevoflurane and remifentanil. Given the observed changes over the following minutes, a preliminary diagnosis of malignant hyperthermia was considered, and the patient's temperature was monitored. Upon an increase in body temperature and further clarification of the findings associated with malignant hyperthermia, the protocol was applied, resulting in a diagnosis of malignant hyperthermia. The patient was then transferred to the anesthesia intensive care unit for further treatment, as his clinical findings demonstrated improvement, and he exhibited a favorable course of treatment in the intensive care unit. This case highlights the importance of awareness of malignant hyperthermia and its presentation.