Succinylcholine Induced Masseter Muscle Rigidity

Abstract

Masseter muscle rigidity (MMR) during general anesthesia is an early warning sign of possible episode  of  malignant  hyperthermia  (MH).  We  report  a  case  of 56-year-oldmale  patient,  posted  for  open cholecystectomy   which   developed   MMR   following   an   intravenous   dose   of   succinylcholine   during induction  of  anesthesia.  Suspecting  MMR  as  an  early  indicator  of  malignant  hyperthermia,  all  the precautions  were  taken  and  after  securing  the  airway  with  endotracheal  intubation  anesthesia  was maintained  with  propofol  infusion,  avoiding  triggering      agents  like  volatile  anesthetic  gases,  muscle relaxants  etc.  Patient  vitals  viz,  temperature,  end  tidal  CO2,  heart  rate  and  blood  pressure  remained within normal limits during intraoperative and postoperative period. Patient wascarefully monitored and investigated  in  postoperative  period  and  a  moderate  rise  in  serum  creatinine  phosphokinase  level  (280 U/L) was recorded at 24 hours. He recovered well and was discharged uneventfully