Possible association of malignant hyperthermia with sevoflurane anesthesia.

A 12-yr-old girl, weighing 48 kg, was scheduled for surgcal correction of idiopathic scoliosis. The patient and her family had no history of neuromuscular disease or of having received general anesthesia. Her laboratory tests, including creatinine phosphokinase (CK), revealed no abnormality. Hydroxydine (50 mg) and atropine (0.5 mg) were given intramuscularly as premedication. General anesthesia was induced with an intravenous infusion of fentanyl(200 pg), thiopental (150 mg), and droperidol (12.5 mg). Endotracheal intubation was facilitated by use of intravenous vecuronium (8 mg). After induction of anesthesia, rectal temperature was 36.5"C and there was no significant change in the first 4 h. There was no skeletal muscle contracture throughout anesthesia, which was maintained with fentanyl, sevoflurane, and nitrous oxide. Fentanyl (100 pg) was given intravenously every hour, and sevoflurane was given in doses of 1.0%1.5% for 4 h before marked increases in heart rate, body temperature, and end-tidal CO, concentration (by infrared capnography) were noted. Rectal temperature increased from 36.7" to 39.8"C in 40 min. Heart rate increased from 90 to 120 beatdmin. We concluded that MH had developed, as analysis of arterial blood gases revealed a pHa of 7.19 and a