TYK126
10-year-old male scheduled for a mastoidectomy in an outpatient center develops severe masseter spasm following induction of anesthesia with sevoflurane and administration of succinylcholine for intubation. Which of the following is most appropriate response?
a) Discontinue inhalation anesthetic and convert to non-triggering agent and complete the case, no further evaluation or monitoring is needed
b) Cancel the surgery and discharge the patient, mention your findings in the chart and no further work-up is needed
c) Cancel surgery, observe the patient for any clinical or biochemical signs of MH
d) Complete the surgery as planned since there is no association between masseter spasm and MH
Answer
Answer c.
If a patient scheduled for an elective surgery develops severe masseter muscle rigidity following exposure to triggering agent then the case should be cancelled especially if the rigidity lasts for more than several minutes. The patient should be monitored for clinical and biochemical signs of MH and should be referred for muscle biopsy. However if the masseter rigidity is moderate then one may consider either canceling the case or continue with a non-triggering anesthetic and monitoring the patient for signs (including laboratory evidence) of MH.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.
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