Unusual responses of muscular rigidity and hypothermia to halothane and succinylcholine; a case report of Smith-Lemli-Opitz (SLO) syndrome
Mizushima, A.; Satoyoshi, M.
Masui. Japanese Journal of Anesthesiology 37(9): 1118-1123
1988
ISSN/ISBN: 0021-4892 PMID: 3193604 Document Number: 319366
A 7 year-old-boy with mental and growth retardation, microcephalus, elfin facies and syndactyly between second and third toes (SLO syndrome) underwent bilateral orchiopexy. He was anesthetized with intravenous thiopental followed by halothane-nitrous oxide-oxygen inhalation combined with caudal analgesia. After intravenous succinylcholine, endotracheal intubation was performed with some difficulties due to unrelaxed masseter muscles. During surgery, the surgeon frequently complained of tightness of the abdominal wall and thigh, although the anesthetic course was smooth except for the rectal temperature dropping to 34.9.degree.C. Postoperatively, marked elevations of serum GOT, GPT, LDH and CPK were observed with occasional hypothermic episode. Three weeks later, he underwent skin grafting for intractable ulcer of the left lower leg under the same anesthetic method where enflurane and vecuronium were selected instead of halothane and succinylcholine. Hypothermia was the only problem during anesthesia and no changes in serum enzymes were observed postoperatively. These findings suggest that there might be some abnormalities latent mainly in skeletal muscles as well as in the temperature regulation system in the patient with SLO syndrome.