Succinylcholine-induced masseter muscle rigidity during bronchoscopic removal of a tracheal foreign body

Maghsoudi, Behzad; Khademi, Bijan

doi:10.1016/j.ijporl.2005.03.034

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…erefore, malignant hyperthermia was the most likely diagnosis. In a similar case, some authors have reported a 4-year-old child who presented with succinylcholine-induced masseter muscle rigidity during emergency bronchoscopic removal of a tracheal foreign body [9].…”

Section: Discussionmentioning

confidence: 90%

Early Recognition and Treatment of Malignant Hyperthermia in Pediatric Patient during Bronchoscopy

Lapisatepun

Arkarattanakul

2020

Case Reports in Anesthesiology

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Malignant hyperthermia is a rare pharmacogenetic disorder triggered by depolarizing muscle relaxant and potent volatile anesthetic agents. An MH crisis is an emergency and life-threatening event requiring early recognition and prompt management. Dantrolene is the specific antagonist of MH. The authors report the case of a 9-year-old boy who underwent an emergency bronchoscopy to remove a foreign body and developed masseter rigidity after succinylcholine and sevoflurane exposure. The anesthesia team diagnosed an MH event, and the event was managed immediately with supportive treatment, dantrolene, being administered within 10 minutes. The patient survived and had a good outcome without any complications. We suggest that it is essential for anesthesia providers to recognize the need for intraoperative vigilance, prompt recognition, and treatment, and dantrolene sodium should be readily available in every hospital.

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Section: Discussionmentioning

confidence: 90%

Early Recognition and Treatment of Malignant Hyperthermia in Pediatric Patient during Bronchoscopy

Lapisatepun

Arkarattanakul

2020

Case Reports in Anesthesiology

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“…Masseter muscle rigidity is normally reported to last for several minutes, although prolonged cases have been described previously. 12,35 In two patients in this series, the rigidity lasted for 8 mins and longer than 15 mins, the latter requiring mask ventilation to complete the anaesthesia. Both patients were MHS, DNA positive (unpublished data, N. Pollock).…”

Section: Masseter Muscle Rigiditymentioning

confidence: 83%

Masseter muscle rigidity and the role of DNA analysis to confirm malignant hyperthermia susceptibility

Hudig

Pollock

Bulger

et al. 2019

Anaesth Intensive Care

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Malignant hyperthermia (MH) is an uncommon, autosomal dominant disorder of skeletal muscle, triggered by inhalational anaesthetics or depolarizing muscle relaxants. Masseter muscle rigidity (MMR) can be regarded as potentially a preceding sign for an MH reaction. Susceptibility to MH can be determined by the in vitro contracture test (IVCT) or DNA analysis where a familial variant is known. Our aims were to review patients with MMR, where IVCT and DNA analysis had been undertaken, to determine if DNA analysis could be used as an initial screening tool for MH susceptibility, and, by reviewing standard monitored variables (SMVs), to determine if any clinical characteristics could be used to differentiate between MMR patients who are MH susceptible (MHS) and those who are not. Patients with MMR were identified from the Palmerston North Hospital MH Reactions Database. IVCT and DNA analysis results were documented. DNA testing was performed retrospectively in the majority of patients as many patients had presented before DNA analysis was available. Forty-one patients were analysed. Fourteen were DNA positive/IVCT positive and six DNA positive only (48% in total), seven were IVCT positive/DNA negative and 14 were IVCT normal. Increased creatine kinase (>18,000 units/L) was consistent with MH susceptibility. Severity of MMR was not linked to MH susceptibility. This study confirmed that DNA analysis can be used as a first-line test for MH susceptibility in patients presenting with MMR (consistent with European MH Group recommendations). Creatine kinase was the only SMV that was significantly different between MHS and MH normal individuals.

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“…16 The decision to proceed with the surgery or not will depend on its urgency and the level of muscular rigidity. 17 Therefore, it is crucial to take the risk of MH into account in patients who experience significant masseter spasm after receiving SCh.…”

Section: Discussionmentioning

confidence: 99%

“…16 The decision to proceed with the surgery or not will depend on its urgency and the level of muscular rigidity. 17…”

Section: Discussionmentioning

confidence: 99%

Challenges in Anesthetic Management of Succinylcholine-induced Masseter Muscle Rigidity in Difficult Airway Patient: A Case Report

Sharma

Chandak

Dev

et al. 2023

Journal of Pharmacology and Pharmacotherapeutics

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The difficult airway is already a challenging situation for anesthesiologists, in that scenario Succinylcholine (Sch) use because of its rapid onset and short duration of action makes it a neuromuscular blockage drug of choice. Development of masseter muscular rigidity is thought to be an early indicator of the occurrence of the dreaded consequence, malignant hyperthermia. Consequently, it is essential to understand the potential side effects of this widely used drug in order to successfully treat the airway. Resulting in the use of videolaryngoscopic intubation along with propofol use and the procedure was completed successfully with no intraoperative or postoperative problems. Here we described a case report of a 33-year-old male patient with a difficult airway posted for open reduction internal fixation of bilateral Lefort’s III fracture, developed Masseter Muscle Rigidity (MMR) following administration of a standard dose of Sch.

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Succinylcholine-induced masseter muscle rigidity during bronchoscopic removal of a tracheal foreign body

Cited by 6 publications

References 7 publications

Early Recognition and Treatment of Malignant Hyperthermia in Pediatric Patient during Bronchoscopy

Early Recognition and Treatment of Malignant Hyperthermia in Pediatric Patient during Bronchoscopy

Masseter muscle rigidity and the role of DNA analysis to confirm malignant hyperthermia susceptibility

Challenges in Anesthetic Management of Succinylcholine-induced Masseter Muscle Rigidity in Difficult Airway Patient: A Case Report

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