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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

Malignant hyperthermia (MH) is an abnormal hypermetabolic state of skeletal muscle induced by exposure to potent inhalation anesthetics and succinylcholine. Signs of MH include increases in carbon dioxide production and oxygen consumption, metabolic acidosis, hyperthermia, tachycardia, muscle rigidity, and rhabdomyolysis. The mortality is extremely high, up to 90% if early diagnosis and treatment is unavailable. 1 We report 2 cases of acute fulminant MH complicated with massive rhabdomyolysis during anesthesia for oral and maxillofacial

of surgical procedure as well as the status of the patient. For minor procedures, if possible, it may be ideal to avoid general anesthesia and endotracheal intubation to decrease the chance of respiratory complications. 3 The use of volatile anesthetics is controversial due to the possibility of rhabdomyolysis and hyperkalemia during a prolonged exposure. One theory is that the exposure to volatile agents causes destabilization of the sarcolemma, leaving it susceptible to further insults commonly encountered in the postoperative period such as shivering

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

Pharmacology, 253 Postoperative pain, 127, 203 Prescription drugs, 178 Pressure ulcer, 104 Psychology, 17 Pulse rate increase, 203 Remifentanil, 3 Retropharyngeal dissection, 240 Rhabdomyolysis, 251 Salivary enzymes, 22 SAMBA Clinical Outcomes Registry, 144, 212 SCOR, 144, 212 Sedation, 17, 59, 66, 175 Sedation for elderly, 88 Selective serotonin reuptake inhibitors, 253 Serotonin norepinephrine reuptake inhibitors

from DMD and BMD genetically, we decided to supplement the anesthetic with sevoflurane. We considered using opioids; however, we selected sevoflurane to prevent postoperative respiratory depression and any risk of prolonged apnea. As a result, there was no delay in recovery from the anesthetic, and the patient was extubated 15 minutes after the end of the operation. This case supports the idea that sevoflurane can be used for patients with FCMD. The development of malignant hyperthermia and rhabdomyolysis in general anesthesia for patients with progressive

GSD-0a due to her characteristic features. Patients with GSD have been reported to be at risk for malignant hyperthermia 2 or myalgia, 3 although GSD-0a and GSD-0b have not been associated with an increased risk of malignant hyperthermia. Several reports have indicated that patients with GSD-0a are at risk of intraoperative hypoglycemia, extubation difficulties, acute renal failure due to rhabdomyolysis, and cardiac insufficiency. 4 However, she experienced metabolic acidosis, elevated body temperature/hyperthermia, and postoperative creatine phosphokinase

Rhabdomyolysis After Malignant Hyperthermia: Report of Two Cases (case report), 21 Finkelman M, see Sadi H, 46 Fukayama H, see Yoshikawa F, 153 Gutenberg LL, Methemoglobin Levels in Generally Anesthetized Pediatric Dental Patients Receiving Prilocaine Versus Lidocaine (scientific report), 99 Hersh EV, see Saraghi M, 178 Ishikawa M, see Yoshikawa F, 153 Jaber A, Effect of Massage on the Efficacy of the Mental and Incisive Nerve Block (scientific report), 15 Jauhar S, see Jaber A, 15 Jiang H, see Fang S

discussed: those with a family history of genetic predisposition to MH, those with diseases associated with MH susceptibility, and patients with myotonic disorders that are associated with non-MH anesthetic-induced rhabdomyolysis. Phenotypes associated with MH susceptibility are presented as well as a list of diseases associated with non-MH anesthetic-induced rhabdomyolysis. Recommendations are summarized in a table at the end of the article. Comment: Significant morbidity arising from MH ranges from 25% to 35%, while mortality may be as high as 9.5%. The

of rhabdomyolysis. 13 , 14 It is therefore unlikely that strict malignant hyperthermia preparation would be necessary for an MD patient. However, it is recommended to avoid depolarizing neuromuscular blockers for prevention of rhabdomyolysis, which has been associated with neuromuscular and mitochondrial disorders. 15 Longer-acting nondepolarizing neuromuscular blockers should also be avoided, as they may have prolonged effects in patients with mitochondrial myopathies. 16 Many anesthetic agents suppress mitochondrial function, which is of greater concern