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  • Title: Suxamethonium, masseter spasm and later malignant hyperthermia.
    Author: Ramirez JA, Cheetham ED, Laurence AS, Hopkins PM.
    Journal: Anaesthesia; 1998 Nov; 53(11):1111-6. PubMed ID: 10023282.
    Abstract:
    A 25-year-old man admitted with severe upper torso trauma displayed masseter muscle spasm after suxamethonium given during resuscitation. Anaesthesia was initially maintained with intravenous agents during transfer and X-ray angiography. However, during surgery to correct a brachial artery injury, malignant hyperthermia was triggered when isoflurane was given, 2.5 h after the suxamethonium. He responded to treatment, including dantrolene administration. Peak serum and urine myoglobin were 12,947 micrograms.l-1 and 54,571 micrograms.l-1, respectively, while maximum serum creatinine kinase was 17,300 IU. The patient made an uneventful recovery and later proved positive for malignant hyperthermia susceptibility on muscle contracture tests.
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