Althesin anesthesia and malignant hyperthermia
Shimonaka, H.; Yamamoto, M.; Suzuki, A.; Suezawa, Y.; Tanahashi, T.; Uematsu, H.; Ohtsuka, S.; Miyagishima, T.
Masui. Japanese Journal of Anesthesiology 30(5): 458-465
1981
ISSN/ISBN: 0021-4892 PMID: 7277689 Document Number: 168825
During the past 10 yr increasing numbers of cases of malignant hyperthermia occurring during or following anesthesia have been reported but the pathological genesis of the disease is not clear and methods of prophylaxis have not been established. It is difficult to select an appropriate anesthetic for malignant hyperthermia susceptible patients. In Aug. 1979, a 6 yr old boy weighing 23 kg who had been identified as a malignant hyperthermia susceptible patient after N2O-O2-halothane anesthesia for pelvis osteotomy in Dec. 1978, uneventfully underwent the same surgical procedure on the other side of his hip joint under Althesin anesthesia. Premedications were i.m. meperidine, levallorphan tartrate and atropine sulfate 1 h before anesthesia. Induction was carried out by an i.v. injection of Althesin and anesthesia was maintained by i.v. injection of Althesin by microdrip method. The dose of Althesin was 0.4 ml/kg per h and supplemented by 75% nitrous oxide in oxygen. The course of the 2nd operation was uneventful. No abnormal body temperature and muscle rigidity were found. Although slight elevations of serum enzyme were detected postoperatively, these changes were within the normal level which was found in patients who had the same operation without development of malignant hyperthermia. Althesin may be one of the agents of choice in anesthesia for malignant hyperthermia susceptible patients.