RHABDOMYOLYSIS AND ANESTHESIA - A REPORT OF 2 CASES AND REVIEW OF THELITERATURE

Rhabdomyolysis occurred in two apparently healthy boys aged 9.5 and 5. 5 years after general anesthesia with suxamethonium. Mild hyperkalemia and renal failure were observed in the first patient, who was subsequ ently diagnosed with Becker dystrophy, In the second patient, the clin ical presentation was not classic for malignant hyperthermia and a mus cle biopsy failed to disclose any pathological finding, A review of th e literature revealed 66 pediatric cases (56 boys and 10 girls) of ane sthesia-associated rhabdomyolysis. Forty-nine (74%) cases were caused by an underlying, mostly unrecognized congenital muscle disease, and 1 4 (21%) cases were caused by malignant hyperthermia susceptibility, Hy perkalemia (23 patients), cardiac arrhythmias (38 patients), renal fai lure (4 patients), and death (11 patients) were the most serious compl ications of anesthesia-associated rhabdomyolysis, The neuromuscular bl ocking agent suxamethonium had been used in at least 43 of the patient s reported in the literature. (C) 1996 by Elsevier Science Inc. All ri ghts reserved.