Abstract
We experienced three atypical cases of malignant hyperthermia (MH) who presented with mild hyperthermia, a transient muscle rigidity and myoglobinuria after appendctomy under general anesthesia, and confirmed the elevation of serum muscle destructive enzyme, especially creatine phosphokinase (CPK) in these cases. Then, we analyzed the influence of anestesia method on CPK after appendectomy and studied the condition of occurrence of this condition.
The factors which appeared to the postoperative elevation of CPK in the 117 appendectomized cases were studied using multivariate analysis. The most contributing factor was the dose of SCC. It was followed by age, sex and the postoperative fever in this order. Duration of anesthesia, the dose of halothane and preoperative CPK levels were not correlated with postoperative CPK. A high postoperative CPK level was commonly found in a group of patients that had been administered large doses of SCC of more than 1mg/kg or in an age group from 15 to 40 years. Therefore, it is advisable to use spinal anesthesia on appendectomy, because general anesthesia with large doses of SCC seemed to be related to MH.
