HALOTHANE INDUCED REVERSIBLE MUSCLE RIGIDITY

A WARNING SIGN OF MALIGNANT HYPERTHERMIA?

Abstract

Malignant hyperthermia is a nightmare for an
anaesthesiologist. Proper preanaesthetic assessment is
mandatory to get some relevant clue regarding the probability
of this syndrome. Anaesthesiologist must depend heavily upon
his clinical judgement in the absence of sophisticated
laboratory investigations as well as advanced monitoring
facilities in our developing country. We present a case of a
young civilian patient who developed gradual muscular rigidity
of almost all of his skeletal muscles following induction by inj
Diprivan and exposure to halothane vapours. The rigidity was
gone after we switched off the halothane and recurred as the
halothane was restarted. This clearly was a case of reversible
muscle rigidity and could have followed by overt MH, had we
used succinyl choline or persisted with halothane inhalation Bwt.
Halothane 2% was administered in oxygen and nitrous
oxide mixture through mask and he was allowed to breathe
spontaneously. No parenteral analgesics were administered.
The surgeon was asked to proceed with the surgery. About 2-
3 minutes later, a stiffness of his jaw muscles was noticed.
The surgeon complained of increased tightness of perianal
muscles. His limb muscles also felt taught. The possibility of
malignant hyperthermia flashed in the mind of the
anaesthesiologist.