Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report

Tiago Freire da Fonte; Lucas Gianni Menegaz; Marcos Lopes de Miranda; Rodrigo Montebello de Araújo; Carlos Darcy Alves Bersot

doi:doi:10.11648/j.ja.20130103.11

Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report

Tiago Freire da Fonte, Lucas Gianni Menegaz, Marcos Lopes de Miranda, Rodrigo Montebello de Araújo, Carlos Darcy Alves Bersot

Published in Journal of Anesthesiology (Volume 1, Issue 3)

Received: 27 August 2013 Published: 10 November 2013

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Abstract

Malignant hyperthermia (MH) is a rare and autosomal dominant myopathy triggered by volatile anesthetics and depolarizing neuromuscular blocking agents such as succinylcholine and is characterized by an acute hypermetabolic clinical state. This report presents the importance of preoperative preparation and perioperative management of patients with a family history of MH, in which there is no possibility of a diagnostic confirmation. Attention must be directed to the preparation of the anesthetic machine because modern workstations need longer cleansing times than their predecessors.Case Report: A two-year-old male child, weighing 16 kg, with a family history of MH, confirmed by muscular biopsy, underwent an elective umbilical and unilateral inguinal hernioplasty, and postectomy under intravenous general anesthesia associated with a caudal block. The preanesthetic care involves the preparation of the surgical environment and assessment of possible perioperative events. The patient's exhaled CO2 fraction and body temperature were continuously monitored throughout the surgery and immediate postoperative period. The patient recovered without further events and was discharged from the hospital after two days.In a patient with family history of MH the administration of intravenous general anesthesia with the adequate preparation of the surgical environment allowed safe anesthetic management for the proposed surgical procedure.

Published in	Journal of Anesthesiology (Volume 1, Issue 3)
DOI	10.11648/j.ja.20130103.11
Page(s)	21-23
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Malignant Hyperthermia, Anesthetic Management, Anesthetic Machine

References

[1]	Hopkins PM – Malignant hyperthermia: advances in clinical management and diagnosis. Br J Anaesth, 2000; 85:118.
[2]	Larach MG, Gronert GA, Allen GC, Brandom BW, Lehman EB – Clinical Presentation, Treatment, and Complications of Malignant Hyperthermia in North America from 1987 to 2006. Anesth Analg, 2010; 110:498-507.
[3]	Denborough MA, Lovell RRH – Anaesthetic deaths in a family. Lancet, 1960; 2:45.
[4]	Allen GC, Brubaker CL – Human malignant hyperthermia associated with desflurane anesthesia. Anesth Analg, 1998; 86:1328-1331.
[5]	Ranklev-Twetman E – Malignant hyperthermia: the clinical syndrome. Acta Anaesthesiol Belg, 1990; 41(2):79-82.
[6]	Britt B, Orkin FK, Cooperman LH – Complications in Anesthesiology. Philadelphia: JB Lippingcott, 1993; 291-313.
[7]	European Malignant Hyperpyrexia Group: A protocol for the investigation of malignant hyperpyrexia. Br J Anaesth, 1984; 56:1267
[8]	Kim TW, Nemergut ME – Preparation of Modern Anesthesia Workstations for Malignant Hyperthermia-susceptible Patients. Anesthesiology, 2011; 114:205-212.
[9]	Schonell LH, Sims C, Bulsara M – Preparing a new generation anaesthetic machine for patients susceptible to malignant hyperthermia. Anaesth Intensive Care, 2003; 31:58-62.

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APA Style

Tiago Freire da Fonte, Lucas Gianni Menegaz, Marcos Lopes de Miranda, Rodrigo Montebello de Araújo, Carlos Darcy Alves Bersot. (2013). Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report. International Journal of Anesthesia and Clinical Medicine, 1(3), 21-23. https://doi.org/10.11648/j.ja.20130103.11

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ACS Style

Tiago Freire da Fonte; Lucas Gianni Menegaz; Marcos Lopes de Miranda; Rodrigo Montebello de Araújo; Carlos Darcy Alves Bersot. Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report. Int. J. Anesth. Clin. Med. 2013, 1(3), 21-23. doi: 10.11648/j.ja.20130103.11

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AMA Style

Tiago Freire da Fonte, Lucas Gianni Menegaz, Marcos Lopes de Miranda, Rodrigo Montebello de Araújo, Carlos Darcy Alves Bersot. Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report. Int J Anesth Clin Med. 2013;1(3):21-23. doi: 10.11648/j.ja.20130103.11

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@article{10.11648/j.ja.20130103.11,
  author = {Tiago Freire da Fonte and Lucas Gianni Menegaz and Marcos Lopes de Miranda and Rodrigo Montebello de Araújo and Carlos Darcy Alves Bersot},
  title = {Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {1},
  number = {3},
  pages = {21-23},
  doi = {10.11648/j.ja.20130103.11},
  url = {https://doi.org/10.11648/j.ja.20130103.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20130103.11},
  abstract = {Malignant hyperthermia (MH) is a rare and autosomal dominant myopathy triggered by volatile anesthetics and depolarizing neuromuscular blocking agents such as succinylcholine and is characterized by an acute hypermetabolic clinical state. This report presents the importance of preoperative preparation and perioperative management of patients with a family history of MH, in which there is no possibility of a diagnostic confirmation. Attention must be directed to the preparation of the anesthetic machine because modern workstations need longer cleansing times than their predecessors.Case Report: A two-year-old male child, weighing 16 kg, with a family history of MH, confirmed by muscular biopsy, underwent an elective umbilical and unilateral inguinal hernioplasty, and postectomy under intravenous general anesthesia associated with a caudal block. The preanesthetic care involves the preparation of the surgical environment and assessment of possible perioperative events. The patient's exhaled CO2 fraction and body temperature were continuously monitored throughout the surgery and immediate postoperative period. The patient recovered without further events and was discharged from the hospital after two days.In a patient with family history of MH the administration of intravenous general anesthesia with the adequate preparation of the surgical environment allowed safe anesthetic management for the proposed surgical procedure.},
 year = {2013}
}

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TY  - JOUR
T1  - Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report
AU  - Tiago Freire da Fonte
AU  - Lucas Gianni Menegaz
AU  - Marcos Lopes de Miranda
AU  - Rodrigo Montebello de Araújo
AU  - Carlos Darcy Alves Bersot
Y1  - 2013/11/10
PY  - 2013
N1  - https://doi.org/10.11648/j.ja.20130103.11
DO  - 10.11648/j.ja.20130103.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 21
EP  - 23
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ja.20130103.11
AB  - Malignant hyperthermia (MH) is a rare and autosomal dominant myopathy triggered by volatile anesthetics and depolarizing neuromuscular blocking agents such as succinylcholine and is characterized by an acute hypermetabolic clinical state. This report presents the importance of preoperative preparation and perioperative management of patients with a family history of MH, in which there is no possibility of a diagnostic confirmation. Attention must be directed to the preparation of the anesthetic machine because modern workstations need longer cleansing times than their predecessors.Case Report: A two-year-old male child, weighing 16 kg, with a family history of MH, confirmed by muscular biopsy, underwent an elective umbilical and unilateral inguinal hernioplasty, and postectomy under intravenous general anesthesia associated with a caudal block. The preanesthetic care involves the preparation of the surgical environment and assessment of possible perioperative events. The patient's exhaled CO2 fraction and body temperature were continuously monitored throughout the surgery and immediate postoperative period. The patient recovered without further events and was discharged from the hospital after two days.In a patient with family history of MH the administration of intravenous general anesthesia with the adequate preparation of the surgical environment allowed safe anesthetic management for the proposed surgical procedure.
VL  - 1
IS  - 3
ER  -

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Author Information

Tiago Freire da Fonte

Department of Anesthesia, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Lucas Gianni Menegaz

Department of Anesthesia, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Marcos Lopes de Miranda

Department of Anesthesia, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Rodrigo Montebello de Araújo

Department of Anesthesia, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Carlos Darcy Alves Bersot

Department of Anesthesia, Hospital Federal da Lagoa, Rio de Janeiro, Brazil

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APA Style

Tiago Freire da Fonte, Lucas Gianni Menegaz, Marcos Lopes de Miranda, Rodrigo Montebello de Araújo, Carlos Darcy Alves Bersot. (2013). Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report. International Journal of Anesthesia and Clinical Medicine, 1(3), 21-23. https://doi.org/10.11648/j.ja.20130103.11

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ACS Style

Tiago Freire da Fonte; Lucas Gianni Menegaz; Marcos Lopes de Miranda; Rodrigo Montebello de Araújo; Carlos Darcy Alves Bersot. Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report. Int. J. Anesth. Clin. Med. 2013, 1(3), 21-23. doi: 10.11648/j.ja.20130103.11

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AMA Style

Tiago Freire da Fonte, Lucas Gianni Menegaz, Marcos Lopes de Miranda, Rodrigo Montebello de Araújo, Carlos Darcy Alves Bersot. Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report. Int J Anesth Clin Med. 2013;1(3):21-23. doi: 10.11648/j.ja.20130103.11

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@article{10.11648/j.ja.20130103.11,
  author = {Tiago Freire da Fonte and Lucas Gianni Menegaz and Marcos Lopes de Miranda and Rodrigo Montebello de Araújo and Carlos Darcy Alves Bersot},
  title = {Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {1},
  number = {3},
  pages = {21-23},
  doi = {10.11648/j.ja.20130103.11},
  url = {https://doi.org/10.11648/j.ja.20130103.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20130103.11},
  abstract = {Malignant hyperthermia (MH) is a rare and autosomal dominant myopathy triggered by volatile anesthetics and depolarizing neuromuscular blocking agents such as succinylcholine and is characterized by an acute hypermetabolic clinical state. This report presents the importance of preoperative preparation and perioperative management of patients with a family history of MH, in which there is no possibility of a diagnostic confirmation. Attention must be directed to the preparation of the anesthetic machine because modern workstations need longer cleansing times than their predecessors.Case Report: A two-year-old male child, weighing 16 kg, with a family history of MH, confirmed by muscular biopsy, underwent an elective umbilical and unilateral inguinal hernioplasty, and postectomy under intravenous general anesthesia associated with a caudal block. The preanesthetic care involves the preparation of the surgical environment and assessment of possible perioperative events. The patient's exhaled CO2 fraction and body temperature were continuously monitored throughout the surgery and immediate postoperative period. The patient recovered without further events and was discharged from the hospital after two days.In a patient with family history of MH the administration of intravenous general anesthesia with the adequate preparation of the surgical environment allowed safe anesthetic management for the proposed surgical procedure.},
 year = {2013}
}

Copy | Download

TY  - JOUR
T1  - Anesthetic Management of a Child with Family History of Malignant Hyperthermia: Case Report
AU  - Tiago Freire da Fonte
AU  - Lucas Gianni Menegaz
AU  - Marcos Lopes de Miranda
AU  - Rodrigo Montebello de Araújo
AU  - Carlos Darcy Alves Bersot
Y1  - 2013/11/10
PY  - 2013
N1  - https://doi.org/10.11648/j.ja.20130103.11
DO  - 10.11648/j.ja.20130103.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 21
EP  - 23
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ja.20130103.11
AB  - Malignant hyperthermia (MH) is a rare and autosomal dominant myopathy triggered by volatile anesthetics and depolarizing neuromuscular blocking agents such as succinylcholine and is characterized by an acute hypermetabolic clinical state. This report presents the importance of preoperative preparation and perioperative management of patients with a family history of MH, in which there is no possibility of a diagnostic confirmation. Attention must be directed to the preparation of the anesthetic machine because modern workstations need longer cleansing times than their predecessors.Case Report: A two-year-old male child, weighing 16 kg, with a family history of MH, confirmed by muscular biopsy, underwent an elective umbilical and unilateral inguinal hernioplasty, and postectomy under intravenous general anesthesia associated with a caudal block. The preanesthetic care involves the preparation of the surgical environment and assessment of possible perioperative events. The patient's exhaled CO2 fraction and body temperature were continuously monitored throughout the surgery and immediate postoperative period. The patient recovered without further events and was discharged from the hospital after two days.In a patient with family history of MH the administration of intravenous general anesthesia with the adequate preparation of the surgical environment allowed safe anesthetic management for the proposed surgical procedure.
VL  - 1
IS  - 3
ER  -

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