Malignant hyperthermia as a rare complication of local lidocaine injection:A case report  

作　　者：Mukosolu Florence Obi Manveer Ubhi Vikhyath Namireddy Chelsea Noel Manjari Sharma Frederick N.Campos Yash Garg 

机构地区：[1]Department of Internal Medicine,Wyckoff Heights Medical Center,New York,NY 11237,United States [2]Department of Medicine,St.Georges University School of Medicine,True Blue 38902,Grenada

出　　处：《World Journal of Anesthesiology》2023年第1期1-7,共7页世界麻醉学杂志

摘　　要：BACKGROUND Malignant hyperthermia(MH)is a hypermetabolic disorder of skeletal muscles triggered by exposure to volatile anesthetics and depolarizing muscular relaxants.It manifests with clinical presentations such as tachycardia,muscle rigidity,hyperpyrexia,and rhabdomyolysis in genetically predisposed individuals with ryanodine receptor or calcium voltage-gated channel subunit alpha1 S mutations.Local anesthetics,such as lidocaine,are generally considered safe;however,complications can arise,albeit rarely.Lidocaine administration has been reported to induce hypermetabolic reactions resembling MH in susceptible individuals.The exact mechanism by which lidocaine might trigger MH is not fully understood.Although some mechanisms are postulated,further research is needed for a better understanding of this.CASE SUMMARY We present the case of MH in a 43-year-old male patient with an unknown genetic predisposition following a lidocaine injection during a dental procedure.This case serves as a reminder that while the occurrence of lidocaine-induced MH is rare,lidocaine can still trigger this life-threatening condition.Therefore,caution should be exercised when administering lidocaine to individuals who may be susceptible to MH.It is important to note that prompt intervention played a crucial role in managing the patient’s symptoms.Upon recognizing the early signs of MH,aggressive measures were initiated,including vigorous intravenous normal saline administration and lorazepam.Due to the effectiveness of these interventions,the administration of dantrolene sodium,a specific antidote for MH,was deferred.CONCLUSION This case highlighted the significance of vigilant monitoring and swift action in mitigating the detrimental effects of lidocaine-induced MH.Caution should be exercised when administering lidocaine to individuals who may be predisposed to MH.It is very important to be aware and vigilant of the signs and symptoms of MH as early recognition and treatment intervention are important to prevent serious complications

关 键 词：Malignant hyperthermia TACHYARRHYTHMIA LIDOCAINE Local anesthesia Dantrolene sodium Genetic mutation Case report 

分 类 号：R73[医药卫生—肿瘤]