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May 1986

Markedly Delayed Postoperative Malignant Hyperthermia

Author Affiliations

From the Departments of Otolaryngology (Drs Souliere and Kirchner) and Anesthesia (Dr Weintraub), Yale-New Haven (Conn) Hospital.

Arch Otolaryngol Head Neck Surg. 1986;112(5):564-566. doi:10.1001/archotol.1986.03780050088017

• Malignant hyperthermia (MH) may be triggered by exposure to commonly employed anesthetic agents and muscle relaxants, and often manifests itself during the period of anesthesia. Delayedonset MH occurring one to four hours postoperatively has been described in isolated case reports. A case of delayedonset MH occurred 11 hours following routine tonsillectomy and adenoidectomy. The patient demonstrated tachypnea, tachycardia, hyperthermia, and metabolic acidosis. Prompt intravenous administration of dantrolene sodium was therapeutic. Serial serum creatine phosphokinase evaluation verified the diagnosis of MH. The implications of delayed-onset MH and the importance of preoperative screening for potentially susceptible individuals are discussed.

(Arch Otolaryngol Head Neck Surg 1986;112:564-566)