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  • Title: [Difficult tracheal intubation in a patient suspected of malignant hyperthermia].
    Author: Nikaido Y, Murao K, Ikeda S, Sakamoto S, Uchiyama Y, Shingu K.
    Journal: Masui; 2003 Feb; 52(2):162-4. PubMed ID: 12649873.
    Abstract:
    We report anesthetic management of a patient suspected of malignant hyperthermia with difficult tracheal intubation. A 64-year-old man was scheduled for a fixation of humerus bone fractures in prone position. He had a history of difficult tracheal intubation due to masseter spasm, and his niece was suspected to be malignant hyperthermia. Anesthesia was induced with propofol using a target controlled infusion. No muscle relaxant was given and spontaneous breathing was maintained. Trials for tracheal intubation failed whenever using a standard laryngoscope, a bronchofiberscope, a laryngeal mask airway or an intubating laryngeal mask airway. Resecting the epiglottic elevating bar of an intubating laryngeal mask airway enabled fiberoptic tracheal intubation. No symptom suggesting malignant hyperthermia developed.
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