Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0024591 (malignant hyperthermia)
 2,353 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 55-year-old woman with congenital myotonia (Becker type), diagnosed by muscle biopsy and gene examination, underwent a right lower lobectomy assisted with thoracoscopy for lung cancer. After epidural tube replacement at T 9-10, general anesthesia was introduced with propofol 2.5 mg x kg(-1) and fentanyl 2.5 mcg x kg(-1). Vecuronium was administered prudently for muscle relaxation assessed with T 1 response (%) and train-of-four (TOF) ratio (%). T 1 response decreased to 50% 3 min and disappeared 4 min after vecuronium administration. Then she was intubated with a double lumen endobronchial tube. T 1 increased 25% within 27 min and 75% in 40 min. Surgery was uneventful and completed in 180 min. At the end of the operation, there was neither fading of twitch responses nor tetanic responses, and TOF ratio returned to 100%. An acetylcholinesterase inhibitor was not given. She was extubated when normal spontaneous breathing, clear consciousness and adequate pharyngeal reflex were present 25 min after discontinuing propofol. There were no perioperative adverse events including hyperthermia and myoglobinuria related to malignant hyperthermia. In conclusion, we managed the anesthesia for a patient with congenital myotonia (Becker type) with thoracic epidural anesthesia and total intravenous anesthesia. Non-depolarizing muscle relaxant could be used safely at the same dose as that used in non-myotonic patients, and did not cause malignant hyperthermia.
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PMID:[Anesthetic managements of a patient with congenital myotonia (Becker type)]. 1558 85

A 70-year-old man with lung cancer was scheduled for partial resection of the right lung. Preoperative serum creatine kinase was elevated (1808 IU x l(-1), CK-MM 97%). Acute coronary syndrome was denied by the absence of significant stenosis of coronary artery and the normal segmental wall motion in echocardiography. The other examinations did not reveal the cause of CK elevation. He did not receive dantlorene preoperatively, but the surgical procedure was performed uneventfully without the use of the triggering agents, such as volatile inhalational anesthetic gases and suxamethonium. Thoracic wall was not invaded by the tumor. After the operation, CK went down quickly. It decreased further after the postoperative chemotherapy. We concluded that CK elevation might have been produced by adenocarcinoma itself, judging from the rapid decrease after surgery and the absence of thoracic wall invasion. Though CK elevation may indicate the malignant hyperthermia, we should not delay the surgery too long when there is possibility of CK elevation derived from cancer itself.
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PMID:[How should we manage patients with elevated preoperative creatine kinase? --A case of CK productive lung cancer]. 1757 18