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calcium, potassium, and serum enzymes (creatine phosphokinase [CPK], glutamic oxalic transaminase, glutamate pyruvate transaminase); and elevated concentrations serum myoglobin. 1 Dantrolene sodium is the drug of choice for the treatment of MH because of its ability to stop this catabolic process and lower body temperature. We experienced a patient who developed postoperative hyperthermia after receiving propofol anesthesia during an alveolar cleft bone grafting procedure with a graft from the iliac crest. The patient's condition was characterized by myoglobinuria

Hg and rectal temperature dropped to 37.8°C. The patient was transferred to the intensive care unit (ICU) for further observation. In the ICU, the status of patient deteriorated over the next 48 hours, with creatine phosphokinase (CPK), myoglobin (Mb), and lactate dehydrogenase (LDH) increasing despite diuresis with 60 mg of furosemide and urine alkalization with 250 mL of 5% sodium bicarbonate. Maximal plasma concentrations of CPK and Mb were 119,000 IU/L and 194,550 ng/mL after anesthesia, respectively. Accordingly, the diagnosis of severe

injection of 1.5 mL of 2% lidocaine with 1 : 80,000 epinephrine, 2 pulpectomies were performed, 4 teeth were restored, and 3 teeth were extracted. Fifteen minutes after the end of the operation, the patient was extubated, and recovery from anesthesia was smooth and uneventful. The operation lasted 2 hours 20 minutes and the anesthesia lasted 3 hours 45 minutes. The total infusion of propofol was 312 mg. No complications were observed during or after the operation, and the patient was discharged from the hospital the following day. The serum level of myoglobin had

Rhabdomyolysis refers to the breakdown of skeletal muscle causing the release of intracellular muscle constituents, such as creatinine kinase, myoglobin, and potassium, into the bloodstream. 1 In patients at high risk of rhabdomyolysis, the use of suitable anesthetics, with attention to intravenous fluid management, electrolyte balance, respiration, and metabolism, should be addressed. Here, we report the general anesthetic management of an outpatient with a history of rhabdomyolysis. A 23-year-old man weighing 72 kg with a body

Rhabdomyolysis after General Anesthesia Using Propofol, Rocuronium Bromide and Sevoflurane Yukiko Otsubo, Masahiro Kemmochi*, Yumiko Matsuura*, Hideki Mamiya*, Tatsuya Ichinohe*, and Yuzuru Kaneko 37(1):20-24. Rhabdomyolysis is derived from skeletal muscle cell disruption. The disrupted muscle cells release several intracellular substances such as creatine phosphokinase (CK), lactate dehydrogenase (LDH), myoglobin and potassium into the interstitial space and serum. The main causes of rhabdomyolysis include direct

until the levels began trending downward again. During his stay in the hospital, the patient's highest serum myoglobin level (normal: <90 mcg/L) was recorded at 2354 mcg/L, which indicated a significant amount of skeletal muscle breakdown, consistent with the anticipated rhabdomyolysis associated with MH. After 4 days in the intensive care unit, the patient was transferred to a floor bed, where he was monitored for 3 more days until being discharged, 7 days after general anesthesia was initially induced in the COD. Follow-up The