Malignant hyperthermia following rhinoplasty: a case report

Malignant hyperthermia is a rare and fatal disorder. A 16-year-old male patient was a candidate for rhinoplasty surgery with no history of disease and previous surgery, negative family history and no history of medication use in the operating room. Maintenance of anesthesia was performed with O2, NO2 (50% -50%) and MAC isoflurane 1. Gradually, from the 80th minute after the start of the operation, the patient had a tachycardia and the SPO2 began to decrease, reaching 93%, and the ETCO2 increased. While the tachycardia was still present, the patient's temperature rose to 38.5 ° C with a tympanic thermometer. The isoflurane was stopped immediately. Hyperventilation began and Dantrolen was administered at a dose of 2.5 mg / kg. Cooling of the patient began with cold saline infusion and ice gavage and bladder lavage with ice and cooling of the body surface. During this time, the patient's rhythm changed to V.Tack, followed by V.Fib, and finally cardiac arrest. Resuscitation was performed. At 110 minutes after the surgery, the patient's rhythm returned to V.Tak and V.fib, and cardiac arrest occurred, and resuscitation was performed. After 10 minutes, a pulse was established. The patient was transferred to the ICU. About 6 hours after entering the ICU, the patient had cardiac arrest and CPR did not respond and the patient died. According to the results of the above study, the most important point is suspecting the occurrence of this syndrome and also the immediate start of treatment immediately after the onset of symptoms.