Desflurane, Malignant Hyperthermia, and Release of Compartment Syndrome

Abstract

We describe a case of suspected malignant hyperthermia in a healthy 20-yr-old man. The patient underwent urgent release of upper extremity compartment syndrome as a result of traumatic vascular injury. After 3 h of general anesthesia with desflurane, he developed a hypermetabolic state (hypercarbia, hyperthermia, hyperkalemia, and metabolic acidosis), consistent with the diagnosis of malignant hyperthermia. Cardiovascular instability coincided with reperfusion of the injured extremity. Treatment with dantrolene and supporting measures restored cardiovascular stability. Three days later he underwent a successful second surgery under regional block with total IV anesthesia.

Muscular body build and male sex are independently associated with malignant hyperthermia susceptibility

“…13 Twenty-five percent of severe MH episodes have occurred in elite athletes. 12 There have also been other reports of athletes suffering MH episodes both with 14,15 and without exposure to anesthesia. [16][17][18] It was previously noted that three of 25 Danish individuals who experienced MH episodes were elite athletes competing at the international and Olympic levels.…”