1/8. Suxamethonium-induced rhabdomyolysis in a healthy middle-aged man.A 43-year-old man developed rhabdomyolysis after uvulo- palatopharyngoplasty. After induction with thiopentone and suxamethonium the anesthesia was maintained with halothane. The patient responded to treatment and made an uneventful recovery. In earlier reports of rhabdomyolysis after general anaesthesia with halothane and suxamethonium almost all the patients had malignant hyperthermia (MH) or muscular dystrophy. About 50% of malignant hyperthermia patients carry a mutation in the RYR1 gene. Our patient did not have mutations in the four MH-associated genes tested, but the total amount of different mutations is by now about twenty. Therefore, despite these negative tests rhabdomyolysis may be a sign of subclinical malignant hyperthermia which cannot be ruled out by our investigations. This rare case of rhabdomyolysis in a healthy man suggests careful monitoring of the patient when-ever suxamethonium is used.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/8. succinylcholine-induced rhabdomyolysis in a healthy child.A case of rhabdomyolysis occurred in a healthy boy 9 years of age after general anaesthesia. succinylcholine, nitrous oxide and isoflurane were used for induction and maintenance of anaesthesia. Patient developed severe muscle pain, myoglobinuria, haemoglobinuria. Also creatinine phosphokinase was elevated up to 10,694 IU/L. Management was prompt and he was discharged home the third day in good condition. The injection of succinycholine may have precipitated rhabdomyolysis. This is a rare complication of succinylcholine without the disastrous outcome of renal failure, hyperkalaemia or cardiac arrest.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
3/8. rhabdomyolysis and acute renal failure following a single dose of succinylcholine.A 30-year old with rhabdomyolysis and acute renal failure is presented. The attack followed a minor operation under general anaesthesia during which succinylcholine was administered as muscle relaxant. The fasciculations which occurred immediately after injection of succinylcholine may possibly have precipitated rhabdomyolysis.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/8. Fatal rhabdomyolysis complicating general anaesthesia in a child with Becker muscular dystrophy.A 6-yr-old boy who presented with brown urine due to myoglobinuria and who was otherwise virtually asymptomatic was diagnosed as having Becker muscular dystrophy on the basis of a greatly elevated creatine kinase, muscle biopsy, dystrophin analysis, and a deletion of exons 3-7 in the dystrophin gene. Fifteen months later, during a general anaesthetic for dental treatment, he had a cardiac arrest associated with acute rhabdomyolysis, hyperkalaemia and hypocalcaemia. He died 4 days later. This case is reported to highlight this rare but potentially fatal complication of anaesthesia in muscular dystrophy, and to discuss possible ways of preventing such a catastrophe.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
5/8. Cardiac arrest after isoflurane anaesthesia in a patient with Duchenne's muscular dystrophy.An 8-year-old boy known to have Duchenne's muscular dystrophy suffered a cardiac arrest 10 minutes after he regained consciousness after isoflurane anaesthesia for an orchidopexy procedure. resuscitation was successful 2 hours after the start of external cardiac compression and after correction of hyperkalaemia and the administration of dantrolene. He later developed myoglobinuria elevated creatine kinase and a metabolic and respiratory acidosis. He demonstrated a delayed increase in rectal temperature.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
6/8. Fatal complications of neuroleptic drugs. A clinico-pathological study of three cases.We report three cases of fatal hyperthermia in the course of neuroleptic drug treatment. One patient developed his symptoms within hours after a single drug dose whereas the two others had a prolonged symptomatology which lasted for several days after the administration of different neuroleptic drugs. Biochemical events included diffuse intravascular coagulation, muscle cell necrosis and acute renal failure. rhabdomyolysis was proved pathologically in two patients but brain lesions were atypical in all three cases. We conclude that the biochemical and pathological abnormalities seen in these patients are those which have been described by some authors in the malignant hyperthermia syndrome after anaesthesia. The symptomatology however can be insidious and the syndrome can develop after withdrawal of the drugs.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
7/8. Anaesthesia induced rhabdomyolysis--a case report.Anaesthesia-induced rhabdomyolysis (air) is a rare but serious complication of general anaesthesia. We report the occurrence of this event in a previously healthy three-year-old male, with a strongly positive family history of Duchenne muscular dystrophy. Following an uneventful anaesthetic, which included succinylcholine, myoglobinuria developed and led to renal failure which fortunately reversed with conservative treatment. Based on review of reports of similar cases, it is clear that succinylcholine should be avoided in paediatric patients with known myopathy or at high risk for latent myopathy.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
8/8. succinylcholine-induced cardiac arrest in children with undiagnosed myopathy.Two paediatric cases are reported in which unexpected, life-threatening arrhythmias occurred. Routine induction of general anaesthesia with thiopentone, 5 mg.kg-1, in one and with halothane in the other, and succinylcholine 1.25-1.5 mg.kg-1 i.v. was followed by the development of wide complex tachyarrhythmia with hypotension in the first case and asystole in the second case despite pre-treatment with atropine in both cases. The first patient was resuscitated with tracheal intubation, 100% oxygen, manual ventilation and intravenous lidocaine and bicarbonate. The second patient required intubation, manual ventilation, 12 min of CPR and i.v. calcium, epinephrine and bicarbonate, as well as DC counter shock. Neither patient received dantrolene. Early recovery in both patients was uneventful with no neurological sequelae. Subsequent investigations revealed the presence of a dystrophin-deficient muscular dystrophy, duchenne muscular dystrophy and Becker muscular dystrophy respectively, previously unsuspected, in both patients. The aetiology of the observed arrhythmias was presumably hyperkalaemia, secondary to succinylcholine-induced rhabdomyolysis. It is suggested that when faced with sudden, life-threatening arrhythmias following succinylcholine at induction of anaesthesia for paediatric patients, clinicians should include occult myopathy in the differential diagnosis, and thus consider the aggressive management of hyperkalaemia in addition to basic resuscitative efforts.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |