SEVERAL excellent articles concerning malignant hyperthermia appeared during 1969.1-6 The subject is of special interest to the otolaryngologist because while fortunately a rare complication of general anesthesia, it carries a mortality approximating 75%. Malignant hyperthermia is characterized by a rapid rise in body temperature, profound acidosis, tissue hypoxia, hypovolemia, and muscle rigidity. Patient survival appears to depend almost entirely on prompt recognition and treatment. The most frequent early warning sign is difficulty in intubation because of masseteric spasm. This prolonged spasm of the masseter muscles is an important early warning sign and can occur with or without the use of succinylcholine.
Cyanosis of the skin which persists despite adequate ventilation and high oxygen flow is another common finding. It may become apparent early in the anesthetic. This change appears to be due to myoglobulinemia, the result of muscle cell destruction. Rapid shallow respirations and tachycardia are also noted,
Merifield DO. Anesthesiology 1969. Arch Otolaryngol. 1971;93(2):213–215. doi:10.1001/archotol.1971.00770060299022
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