A boy presenting for oesophagoscopy developed myoglobinuria during convalescence from the procedure. A susceptibility to malignant hyperpyerexia was considered in the differential diagnosis but was felt to be unlikely on the basis of in vitro testing of muscle biopsy specimens. A review of relevant papers suggests that rhabdomyolysis of significant degree following suxamethonium administration may be more common than generally appreciated, particularly in children.
References
1.
AiraksinenM. M., and TammistoT. (1966): “Myoglobinuria after intermittent administration of succinyl choline during halothane anaesthesia”, Clin. Pharmacol. Titer., 7, 583.
2.
BennikeK-Aa, and JarnumS. (1964): “Myoglobinuria with acute renal failure possibly induced by suxamethonium”, Brit. J. Anaesth., 36, 730.
3.
JensenK., BennikeK-Aa, HavelH. K., and OlesenH. (1968): “Myoglobinuria following anaesthesia including suxamethonium”, Brit. J. Anaesth., 40, 329.
4.
RobothamJ. L., and HaddowJ. E. (1976): “Rhabdomyolysis and myoglobinuria in childhood”, Paed. Clin. N. Amer., 23, 279.
5.
RothF., and WuthrichH. (1969): “Clinical importance of hyperkalaemia following suxamethonium administration”, Brit. J. Anaesth., 41, 311.
6.
RyanJ. F., KagenL. J., and HymanA. I. (1971): “Myoglobinaemia after a single dose of succinyl choline”, N. Eng. J. Med., 285, 824.
7.
SchaerH., SteinmannB., JerusalemS., and MaierC. (1977): “Rhabdomyolysis induced by anaesthesia with intra-operative cardiac arrest”, Brit. J. Anaesth., 49, 495.
8.
TammistoT., and AiraksinenM. (1966): “Increase of creatine kinase activity in serum as sign of muscular injury caused by intermittently administered suxamethonium during halothane anaesthesia”, Brit. J. Anaesth., 38, 510.
9.
TammistoT., LeikonenP., and AiraksinenM. (1967): “The inhibitory effect of d-tubocurarine on the increase of serum creatine phosphokinase activity produced intermittent suxamethonium administration during halothane anaesthesia”, Acta Anesthiol. Scand., 11, 333.
10.
WeintraubH. D., HeisterkampD. V., and Cooper-manL. H. (1969): “Changes in plasma potassium concentration after depolarising blockers in anaesthetised man”, Brit. J. Anaesth., 41, 1048.