Management of Malignant Hyperthermia and Pseudocholinesterase Deficiency in Trauma

Authors

Mazen Zamzam, Oakland University William Beaumont School of Medicine Medical Student
Natalie Finazzo, Corewell Health East Resident
Roy Soto, Corewell Health East

Document Type

Conference Proceeding

Publication Date

10-13-2025

Abstract

A 69-year-old male with a history of malignant hyperthermia and pseudocholinesterase deficiency presented with abdominal pain, nausea, and vomiting due to a small bowel obstruction requiring urgent surgery. Anesthetic management was complicated by the need to avoid triggering agents such as succinylcholine and volatile anesthetics, and the patient's atypical response to ester-based drugs. Total intravenous anesthesia with propofol and remifentanil was used, with vigilant temperature and EtCO₂ monitoring. A regional block was avoided due to coagulopathy. Postoperatively, the patient developed delayed emergence, attributed to prolonged action of muscle relaxants. This case highlights key intra operative challenges in managing such high-risk patients.

Comments

American Society of Anesthesiologists, The Anesthesiology Annual Meeting, October 10-14, 2025, San Antonio, TX

Recommended Citation

Zamzam M, Finazzo N, Soto R. Management of malignant hyperthermia and pseudocholinesterase deficiency in trauma. Presented at: American Society of Anesthesiologists, The Anesthesiology Annual Meeting; 2025 Oct 13; San Antonio, TX. Available from:https://www.abstractsonline.com/pp8/#!/21028/presentation/9408