Delayed Onset of Sevoflurane Induced Malignant Hyperthermia in a child with Osteogenesis Imperfecta – An unusual entity
Journal Title: JOURNAL OF MEDICAL COLLEGE CHANDIGARH - Year 2018, Vol 8, Issue 2
Abstract
Malignant hyperthermia (MH) is a rare pharmacogenetic disorder of skeletal muscle calcium regulation, consisting of hypermetabolic response to volatile anaesthetic agents (like halothane, sevoflurane, and desflurane), and succinylcholine. It is seen more commonly in males than females (2:1). The classical signs of malignant hyperthermia are marked rise in body temperature, tachycardia, tachypnea, hypercarbia, increased oxygen consumption, acidosis, muscle rigidity and rhabdomyolysis. In this case report, we present a case of rarely-seen delayed onset malignant hyperthermia-like reaction after the second exposure to sevoflurane in a 2 year old male child with Osteogenesis imperfecta (OI), scheduled to undergo corrective osteotomy under general anaesthesia. Malignant hyperthermia was probably induced by sevoflurane, an inhalation agent of low-inducing probability, despite no prior complication to previous exposure. By virtue of the same, we wish to emphasize the importance of detailed pre-anaesthetic evaluation and preparation before anaesthetizing such patients despite prior uneventful exposure. The anaesthesiologist should be able to recognize the possibility of an atypical MH and be alert for the possible occurrence of MH in susceptible patients
Authors and Affiliations
Puja Saxena, Uma Rathi, Satinder Gombar, Parmanand Gupta, Chandrika Azad
Keywords
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