Abstract
A 11-year-old man, suffering from chronic tympanitis, was anesthetized for tympanoplasty using thiamylal, succinylcholine, nitrous oxide and enflurane, but the operation was stopped because he developed malignant hyperthermia (MH) . MH was succesfully cured with intravenous infusion of dantrolene. One year later he was admitted to our hospital again for the reoperation of tympanoplasty. Because of his episode of MH, we had done prophylactic oral administration of dantrolene preoperatively. As for the anesthesia, we avoided the use of succinylcholine and volatile inhalational anesthetics such as halothane enflurene, and as the anesthetic method to prevent MH, we chose neuroleptanesthesia using droperidol, fentanyl, diazepam, pancuronium bromide and nitrous oxide. On this operation we could prevent MH and the operation was uneventful. The mortality rate of MH has raned highest among complication of modern anesthesia. Therefore when the anesthesia was scheduled for the patient who had episode of MH, we must avoid the use of depolarizing muscle relaxant and volatile anesthetics, and we recommend preoperative prophyactic oral administration of dantrolene and neuroleptanesthesia using droperidol, fentanyl, and pancronium bromide.
