Malignant hyperthermia: patient undergoing limb debridement surgery—a case report

Abstract

Abstract Background Malignant hyperthermia is a rare but potentially fatal clinical emergency, primarily triggered by inhaled volatile anesthetics. It is associated with inherited autosomal-dominant skeletal muscle disorders and typically caused by mutations in muscle calcium channel genes. Owing to its rapid onset and severe complications, prompt diagnosis and intervention are crucial. This case report highlights a unique instance of malignant hyperthermia, emphasizing the importance of early detection and timely treatment in saving a patient’s life. Case presentation A 30-year-old Han Chinese male underwent limb debridement surgery twice within 4 days, and, during the second surgery, he developed signs of malignant hyperthermia following the administration of inhaled anesthetics. The patient presented with hyperthermia, tachycardia, hypercapnia, and masseter spasm. Clinical diagnosis of malignant hyperthermia was confirmed, and immediate treatment with dantrolene was initiated. A multidisciplinary approach was employed to manage the condition, leading to successful stabilization and recovery. The patient ultimately made a full recovery without further complications. After the surgery, the patient underwent genetic testing, and no clear pathogenic genes were found; however, there were some suspicious related genes. Conclusion This case underscores the critical importance of the early recognition of malignant hyperthermia and the prompt administration of dantrolene, which is vital in mitigating its life-threatening consequences. It also highlights the need for thorough preoperative screening for patients at risk of malignant hyperthermia and suggests improvements in treatment protocols to optimize patient outcomes.

Keywords

• Malignant hyperthermia
• Dantrolene
• Gene mutation
• Volatile inhaled anesthetics