Malignant hyperthermia in renal recipient (Case report) Renal transplantasyon alicisinda malign hipertermi (Olgu sunumu)
Turk Anesteziyoloji ve Reanimasyon, cilt.27, sa.10, ss.580-583, 1999 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 27 Sayı: 10
- Basım Tarihi: 1999
- Dergi Adı: Turk Anesteziyoloji ve Reanimasyon
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.580-583
- Anahtar Kelimeler: Anaesthesia, Malignant hyperthermia, Renal transplantation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
In this report, we describe a case of malignant hyperthermia with its clinical course, the steps for treatment and preservation of the function of a kidney allograft. A 22 year-old man in end stage renal failure due to an unidentified etiology was scheduled to receive a kidney from his 50 year-old father. Anaesthesia was induced with alfentanil(lmg) and propofol (2.5 mg/kg). Tracheal intubation was facilitated by administration of atracurium (0.5 mg/kg). Anaesthesia was maintained with nitrous oxide 60 %, oxygen 40 %, and isoflurane 1-1.5 %. The first 5 hours of anaesthesia, vascular anastomosis and uretherovesical implantation were completed uneventfully. At that time heart rate began to rise and sweating was noted, superficial anaesthesia was suspected and alfentanil 1 mg IV was introduced. Within 20-25 minutes heart rate was increased to 165 bpm and body temperature rises to 41°C. Malignant hyperthermia was suspected and warming blanket and anaesthetic gazes were discontinued. Arterial blood gazes showed respiratory and metabolic acidosis. Dantrolen was administrated (2 mg/kg) and whole body cooling was started. During these procedures, furosemid, mannitol and sodium bicarbonate were given. Within 25-30 minutes of dantrolen administration, the temperature and heart rate dropped to 37.5°C and 142 bpm, respectively. Arterial blood gazes improved postoperative urinary examination revealed numerous red blood cells. After treatment with fluids and furosemid renal functions improved gradually. He made a full recovery and was discharged 4 weeks after transplantation.