Malignant Hyperpyrexia During Anesthesia

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Abstract
Malignant hyperpyrexia is a rare complication following anesthesia but one that is fatal in more than 70% of cases. In one case studied the patient's temperature reached 104 F (40.0 C). With vigorous treatment she survived in spite of other life-threatening complications. In the syndrome of fulminant hyperpyrexia, prevention is the prime consideration. If a patient develops muscular rigidity, exceedingly hard muscular fasciculations, or trismus following intravenous administration of succinylcholine, the operative procedure should be postponed unless it is an emergency. Temperature recording should be routinely used on all patients undergoing general anesthesia. If possible, spinal or other forms of conduction anesthesia should be employed in a patient who has shown a paradoxical response to succinylcholine intravenously. If block anesthesia cannot be used, then use of nitrous oxide, oxygen, and curare seems to be a rational technique.

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