The application of combined spinoepidural anesthesia in a patient with malignant hyperthermia susceptibility
Ercan Kurt, Nedim Cekmen, Ertan Piri, Ali Sizlan, Meryem Jefferies
Am J Case Rep 2010; 11:1-4
Background: Malignant Hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle that presents as a hyper metabolic response to potent volatile anesthetics and the depolarizing muscle relaxant succinylcholine, and rarely, in humans, to stresses such as vigorous exercise and heat. We present a case the first operation of a patient with Malignant Hyperthermia susceptibility in Turkey.
Case Report: The MH test was verified by caffeine halothane contracture test and genetic testing by University of Melbourne, department of Medicine, A 47-year-old male presented with signs and symptoms of colesistitis. His father had four malignant hyperthermia episodes, three during operations an one post operation. The patient informed us of a positive MH result in his in vitro halothane contracture test report, and was therefore susceptible to MH.
Conclusions: For the operation we anaesthetized the patient by combined spinoepidural anesthesia with amid type local anesthetic. The cholesistectomy operation was successfully performed without any complications during or after surgery.
Keywords: Laparoscopic cholecystectomy, Malignant Hyperthermia, spinal-epidural anesthesia