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Canadian Journal of Anesthesia, Vol 21, 96-105, Copyright © 1974 by Canadian Anesthesiologists' Society

Procainamide Therapy of Malignant Hyperthermia: Case Report

J. BREBNER M.D., F.R.C.P.(C)1 and J. A. JOZEFOWICZ M.D.1

1 Department of Anaesthesia, Faculty of Medicine, University of Toronto, and Toronto General Hospital

A 40-year-old Italian male of lean muscular physique developed malignant hyperthermia over the course of 11/2 hours during an operation for vagotomy and pyloroplasty. Pre-operative medication was Pantopon® and scopolamine. During operation he received thiopentone, succinylcholine, atropine, N2O/O2, d-Tubocurare, and fentanyl. Only thiopentone, N2O, and fentanyl have been declared safe for use in a patient with malignant hyperthermia. Chlorpromazine was given just prior to making the diagnosis and may have helped in the rapid cooling that was achieved. The mainstay of therapy in the acute situation and in the postoperative period of one week was procainamide. The patient had a rapid recovery which was accurately reflected by his serum CPK levels. We advocate continuous administration of procainamide from the time of diagnosis of malignant hyperthermia until the CPK levels are near to normal again.






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Copyright © 1974 by the Canadian Anesthesiologists' Society.