Delayed Volatile Anesthetic-Associated Rhabdomyolysis With Hypermetabolic Intraoperative Signals in a Previously Healthy Child

Authors

• James Burmeister, Oakland University William Beaumont School of Medicine Medical Student
• Lauren Faraj, Corewell Health East Resident
• Eric Reilly, Corewell Health East Resident

Document Type

Conference Proceeding

Publication Date

10-18-2026

Abstract

A 7-year-old female underwent tympanoplasty under sevoflurane anesthesia without succinylcholine or neuromuscular blockade. Intraoperatively, persistent tachycardia, rising end-tidal CO₂ (36.8 to 57 mmHg), and increasing temperature (35.4°C to 38.0°C) suggested mild hypermetabolism. On postoperative day 1, she developed severe bilateral foot pain, weakness, inability to ambulate, and creatine kinase >20,000 U/L, consistent with anesthesia-associated rhabdomyolysis. Orthopedic and neurologic evaluations were unrevealing. Symptoms improved rapidly with aggressive intravenous hydration. This case highlights that volatile anesthetics alone may rarely precipitate delayed rhabdomyolysis and that subtle intraoperative changes may precede postoperative manifestations warranting malignant hyperthermia evaluation.

Comments

American Society of Anesthesiologists, The Anesthesiology Meeting, October 16-20, 2026, San Diego, CA

Recommended Citation

Burmeister J, Faraj L, Reilly E. Delayed volatile anesthetic-associated rhabdomyolysis with hypermetabolic intraoperative signals in a previously healthy child. Presented at: American Society of Anesthesiologists, The Anesthesiology Meeting; 2026 Oct 18; San Diego, CA. Available from: https://www.abstractsonline.com/pp8/#!/21448/presentation/8919