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Canadian Journal of Anesthesia, Vol 23, 616-623, Copyright © 1976 by Canadian Anesthesiologists' Society

The Use of Procaine in Acquired Malignant Hyperthermia in a Patient with Malignant Melanoma Metastatic to the Parathyroid Gland: A Case Report

HERMAN BORDEN 1, GEORGE J. HUMMER 2, CHARLES W. LANDON 3, and JAMIE PARIS 4

1 Division of Anesthesiology, St. John's Hospital, Santa Monica, California; Anesthesiology, University of California at Los Angeles
2 Department of Pathology, St. John's Hospital, Santa Monica, California; University of California, Los Angeles
3 Department of Surgery, St. John's Hospital, Santa Monica, Ca.; University of California at Los Angeles; V.A. Wadsworth Hospital, Los Angeles
4 Department of Internal Medicine, St. John's Hospital, Santa Monica, Ca.; University of California, Los Angeles

The use of intravenous procaine in the treatment of hyperpyrexia in a patient with hyperparathyroidism has not been previously reported. A case of metastatic malignant melanoma precipitating the syndrome of hypertonicity of muscle, hyperpyrexia, acidemia, hypercalcemia and elevated serum parathormone levels is presented.

Mithramycin was used in an attempt to reduce elevated serum calcium concentrations. The use of intravenous procaine in "caffeine rigor" and malignant hyperthermia due to succinylcholine and halothane formed the basis for its trial in this case.

The relationship between cyclic AMP and calcium ions is discussed in postulating a mechanism of procaine action.






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Copyright © 1976 by the Canadian Anesthesiologists' Society.