Malignant hyperthermia is a potentially fatal hypermetabolic syndrome characterised by hyperpyrexia and skeletal muscle rigidity. It can be induced by all of the currently used inhalation anesthetics or by injection of succinylcholine. A case of malignant hyperthermia was experienced which developed 80 minute after induction of general anesthesia with thiopental sodium, suecinylcholine, halothane, N2O and O2. One and half hours after induction, arrhythmia developed and was followed by unstable blood pressure, hyperpyrexia and muscle rigidity. Anesthesia was terminated and vigorous emergency treatment and dantrolene were administered. The patient recovered normal body temperature and consciousness, but expired about 4 days after induction because of late complication including disseminated intravascular coaggulation. The etiologic factor, clinieal feature, treatment and prevention of Malignant hyperthermia are discussed.
Anesthesia* ; Anesthesia, General ; Anesthetics, Inhalation ; Arrhythmias, Cardiac ; Blood Pressure ; Body Temperature ; Consciousness ; Dantrolene ; Emergency Treatment ; Halothane ; Humans ; Malignant Hyperthermia* ; Muscle Rigidity ; Muscle, Skeletal ; Succinylcholine ; Thiopental

No abstract available.
Adult ; Bone Marrow/*pathology ; Fatal Outcome ; Graft vs Host Disease/etiology ; High-Throughput Nucleotide Sequencing ; Humans ; Liver Cirrhosis/pathology/*therapy ; *Liver Transplantation/adverse effects ; Microsatellite Repeats ; Middle Aged ; Polymerase Chain Reaction ; *Polymorphism, Single Nucleotide ; Transplantation Chimera/*genetics

Pancreatic cancer is usually unresectable upon diagnosis, and treatment aims to optimize the quality of the patient's life by managing symptoms, and, particularly, by providing adequate pain control. When the pain is refractory to opioids, interventions such as celiac plexus neurolysis (CPN) can be considered. Endoscopic ultrasound (EUS)-guided CPN has been introduced for pancreatic cancer. Reported herein is a case of a 75 year-old man with pancreatic cancer who was treated with opioids due to severe abdominal pain. EUS-guided CPN was performed for pain control, and the opioid administration was discontinued as the pain improved dramatically. However, the patient experienced opioid withdrawal symptoms, including anxiety, insomnia, nausea, and vomiting. Thus, although EUS-guided CPN successfully reduced pain in a patient undergoing such treatment and to whom opioid was administered, opioid administration should not be abruptly discontinued. Rather, the opioid dose should be reduced gradually to avoid drug withdrawal.
Abdominal Pain ; Analgesics, Opioid ; Anxiety ; Celiac Plexus ; Humans ; Nausea ; Pancreatic Neoplasms ; Sleep Initiation and Maintenance Disorders ; Substance Withdrawal Syndrome ; Vomiting