Key result
Preoperative suxamethonium triggers life-threatening muscle spasms and ventilation difficulties in undiagnosed myotonia congenita.
Case Report (n=1)
Suxamethonium can cause life-threatening muscle spasms and ventilation difficulties in patients with undiagnosed myotonia congenita.
Highlights suxamethonium risks in undiagnosed myotonia; single case leaves open broader screening validation.
Myotonia congenita (MC) is caused by a defect in the skeletal muscle chloride channel function, which may cause sustained membrane depolarisation. We describe a previously healthy 32-year-old woman who developed a life-threatening muscle spasm and secondary ventilation difficulties following a preoperative injection of suxamethonium. The muscle spasms disappeared spontaneously and the surgery proceeded without further problems. When subsequently questioned, she reported minor symptoms suggesting a myotonic condition. Myotonia was found on clinical examination and EMG. The diagnosis MC was confirmed genetically. Neither the patient nor the anaesthetist were aware of the diagnosis before this potentially lethal complication occurred. We give a brief overview of ion channel disorders including malignant hyperthermia and their anaesthetic considerations.
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Farbu et al. (2003) conducted a case report in Myotonia congenita (n=1). Suxamethonium was evaluated on Life-threatening muscle spasm and secondary ventilation difficulties. Preoperative injection of suxamethonium in an undiagnosed 32-year-old woman with myotonia congenita caused a life-threatening muscle spasm and secondary ventilation difficulties.
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