RÉsumÉ
Un cas d’hyperthermie maligne, complication grave de l’anesthésie, est survenu chez une fillette de 51/2 ans subissant une chirurgie dentaire en clinique dentaire. Grâce aux exigences actuelles pour la pratique de l’anesthésie dans les cliniques dentaires du Québec, ce type de complication anesthésique a pu être bien traité.
Summary
Malignant hyperthermia, a life-threatening complication of anaesthesia, occurred in a 51/2-year-old girl undergoing dental surgery in a dental clinic. During induction, after 20 mg of succi-nylcholine, the anaesthetist noted a moderate rigidity of the mandible that did not interfere with the tracheal intubation. However, after 45 minutes, the temperature rose to 38.8° C, pulse was rapid at 160 per minute and the child was slightly cyanosed. The diagnosis of malignant hyperthermia was made (the temperature eventually reached 40.8° C). The child was immediately treated with refrigeration, procainamide and sodium bicarbonate. She was then moved to a hospital centre where the treatment was continued and she recovered completely.
After extensive investigation, we found that the paternal grandfather of the child died at age 58, several hours after a bilateral lumbar sympathectomy under general anaesthesia. The cause of the death, as confirmed by hospital records, was malignant hyperthermia. No genetic counselling was given at that time; this omission has since been corrected.
Early diagnosis and the availability onthe premises of the necessary drugs and equipment to treat such a complication probably saved this child’s life.
In 1975, “La Corporation Professionnelle des Médecins du Québec” published standards for practice of anaesthesia outside a hospital setting. The compliance of the dental clinic with such standards has contributed to the avoidance of a catastrophe.
Article PDF
Avoid common mistakes on your manuscript.
References
King, J.O., Denborough, M.A., &Zapf, P.W. Inheritance of malignant hyperthermia. Lancet Feb. 12, 365 (1972).
Greenfield, S., Bronsther, B., Abrams, M.W., &Rosenberg, H. The malignant hyperthermia syndrome. Clinical Pediatrics16: 808 (1977).
Britt, B.A., Locher, W.G., &Kalow, W. Hereditary aspects of malignant hyperthermia. Can. Anaes. Soc. J.16: 89 (1969).
Moulds, R.F.W. &Denborough, M.A. Biochemical basis of malignant hyperpyrexia. B.M.J.2: 241 (1974).
Kaplan, A., Bergeron, P.S., Gregg, S.A., &Curless, R.G. Malignant hyperthermia associated with myopathy and normal muscle enzymes. J. of Ped.91: 431 (1977).
Vaughan, V.C.,McKay, R.J., &Nelson, W.E. Nelson Textbook of Pediatrics, Ed. 10, Saunders, p. 1547 (1975).
Ellis, F.R., Clarke, I.M.C., Modgill, M., Curie, S., &Harriman, D.G.F. Evaluation of creatinine phosphokinase in screening patients for malignant hyperpyrexia. B.M.J.3: 511 (1975).
Britt, B. Personal communication. University of Toronto (Jan. 1978).
Rueller, J.B. Management of hyperthermia. Can. Med. Ass. J.117: 1372 (1977).
Guide d’Exercice de l’Anesthésie, Corporation Professionnelle des Médecins du Québec, p. 3–4 & suiv. (14 mars 1975).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Martel, A., Spigelblatt, L., Perreault, L. et al. UN cas D’hyperthermie maligne survenu en clinique dentaire. Canad. Anaesth. Soc. J. 26, 55–57 (1979). https://doi.org/10.1007/BF03039455
Issue Date:
DOI: https://doi.org/10.1007/BF03039455