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Case Three was a
patient who presented with possible masseter muscle rigidity (MMR). After succinylcholine
and propofol were given, the anesthesiologist tried to intubate the patient’s trachea.
This was unsuccessful after three attempts. No generalized rigidity was noted. The case
was cancelled. 5 hours later, the patient complained of severe myalgia. Urine was noted to
be very dark red with “large” blood. Laboratory work-up showed: creatine kinase (CK)
of 56,000 IU, and K+ of 4.4 mEq/l . Heart rate, temperature and other vital
signs were normal throughout this episode. The following day: CK was 99,000 IU. Urine was
clear and creatinine was normal. This case, therefore, presented with myalgia and
rhabdomyolysis only without increased metabolism. Was Case Three MH? |