Anaesthetic Considerations for a Seven-Month-Old Infant with Suspected Malignant Hyperthermia: A Case Report

Abstract

Introduction: Malignant hyperthermia (MH) is a life-threatening pharmacogenetic skeletal muscle disorder resulting in increased myoplasmic calcium concentrations leading to sustained muscle contraction. In cases susceptible to MH, a total intravenous intravenous anaesthesia (TIVA) approach is employed to avoid the use of MH triggering agents namely volatile anaesthetics and suxamethonium. Case presentation: In this case report, we present a seven-month-old male infant with MH susceptibility that was scheduled for a rectal biopsy under general anaesthesia. The patient was managed according to MH guidelines and paediatrics dosing schemes for TIVA; using propofol and remifentanil as an adjuvant. The case was management successfully and uneventfully. Conclusion: MH is a potentially life-threatening disorder, hence following the evidence-based precautions and management of patients with suspected MH is key. Moreover, managing a paediatric patient with MH suspicion often impose additional challenges. In this case report, the perioperative considerations for infants with MH suspicion is discussed. Keywords: Malignant Hyperthermia, Total Intravenous Anaesthesia, Steur propofol infusion scheme.