4.1 Article

Propofol-induced rhabdomyolysis: a case report

Publisher

DUSTRI-VERLAG DR KARL FEISTLE
DOI: 10.5414/CP202341

Keywords

rhabdomyolysis; propofol; malignant hyperthermia

Funding

  1. Guangdong Science and Technology Planning Project [2013B051000045]
  2. Guangzhou International Science and Technology Cooperation Project [2012J5100019]
  3. B. Braun Research Fund for Anesthesiology [BBDF-2014-016]

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Objective: To report a case of propofol-induced rhabdomyolysis. In this case, widespread myolysis was detected after induction of anesthesia. Case summary: A 54-year-old female patient was scheduled for a hysterectomy. Beginning shortly after the induction of anesthesia with propofol, several episodes of ventricular fibrillation occurred. Despite intensive care, the patient failed to recover. During most episodes of ventricular fibrillation, marked hyperthermia or hyperkalemia were not observed. Unexplained, widespread myolysis affecting both skeletal and cardiac muscle was observed at autopsy. Discussion: In this patient, the evidence for rhabdomyolysis is robust. Clinical characteristics are similar to those observed in propofol infusion syndrome. The absence of a body temperature over 40 degrees C precludes the possibility of malignant hyperthermia. Widespread rtiabdomyolysis locations cannot be explained by precordial electric shocks. Propofol;is the only drug used in this case that has been reported to induce rhabodomyolysis. Conclusions: Signs of propofol-induced rhabdomyolysis may be different from those of malignant hyperthermia. Even a regular induction dose of propofol for adults could possibly trigger rhabdomyolysis similar to what is observed in children diagnosed with propofol infusion syndrome. Though rare, care should still be taken when administering propofol.

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