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Canadian Journal of Anesthesia, Vol 14, 183-192, Copyright © 1967 by Canadian Anesthesiologists' Society

Hyperpyrexia During Anaesthesia in a Second Member of a Family, With Associated Coagulation Defect Due to Increased Intravascular Coagulation

I. E. PURKIS M.B., B.S., F.F.A.R.C.S.1, O. HORRELT M.D.1, C. G. DE YOUNG M.D.1, R.A. P. FLEMING M.D.1, and G. R. LANGLEY M.D., F.R.C.P.(C)1

1 Departments of Anaesthesia and Medicine, Dalhousie University and Victoria General Hospital, Halifax, Nova Scotia

A death from hyperthermia following an abnormal reaction to succinylcholine is reported, and it is noted that a similar death occurred in a close relative. D-tubocurarine produced relaxation of severe muscle spasm associated with this hyperthermia, and relaxation remained when the patient was cooled into hypothermia but the hypertonicity recurred as a terminal event. Raised serum potassium levels were associated with the hypertonus, and the intervening hypotonic phase was associated with lowered serum potassium levels. Although serum calcium levels remained normal, intravenous calcium gluconate improved the circulatory state of the patient. A consumption coagulopathy was noted during the hypotonic phase, and increased coagulability was noted during the hypertonic phases. Treatment and possible mechanisms of action of succinylcholine in the production of hyperthermia are discussed.






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Copyright © 1967 by the Canadian Anesthesiologists' Society.