Benign hyperthermia following prolonged TIVA with propofol

Purpose: Propofol is widely used for general anesthesia because of its rapi d onset acid recovery. We had four cases that had higher body temperatures toward the end of anesthesia. The etiology of the hyperthermia is discussed . Clinical features: four patients (three male, one female, 22-26 yr of age, weighing 53-57 kg) with facial deformities were anesthetized with propofol infusion (3-10 mg.kg(-1).hr(-1)) and fentanyl (400-1,300 mug) without nitro us oxide, immobilized with vecuronium bromide (18-37 mg) or pancuronium bro mide (31 mg), In order to reduce blood loss and improve the surgical view, tri-nitro-glycerin (TNG) was used in all cases, Osteotomy of maxilla and ma ndible or sagittal split ramus osteotomy of mandible was successfully perfo rmed. Although their body temperatures were normal preoperatively and stabl e during the operation, toward the end of anesthesia tone hour), they incre ased to over 38 degreesC, The room temperature was decreased and the water blanket on the operating table was also decreased, In addition, cool crysta lloid solution was infused. Body temperature returned to normal in the ward and no complications due to the high temperature were seen postoperatively . it is thought that lighter anesthesia was masked by continuous infusion o f propofol and TNG-induced hypotension and that benign hyperthermia occurre d toward the end of anesthesia, Conclusion: Propofol reduces blood pressure, which suggests deep anesthesia . However, care must be taken to maintain the optimum depth of anesthesia d uring propofol anesthesia, especially when deliberate hypotensive anesthesi a is induced.