• Yuki Nikaido, Kohei Murao, Sakahiro Ikeda, Sachiyo Sakamoto, Yuka Uchiyama, and Koh Shingu.
• Department of Anesthesiology, Kansai Medical University, Moriguchi 570-8506.
• Masui. 2003 Feb 1; 52 (2): 162-4.

AbstractWe report anesthetic management of a patient suspected of malignant hyperthermia with difficult tracheal intubation. A 64-year-old man was scheduled for a fixation of humerus bone fractures in prone position. He had a history of difficult tracheal intubation due to masseter spasm, and his niece was suspected to be malignant hyperthermia. Anesthesia was induced with propofol using a target controlled infusion. No muscle relaxant was given and spontaneous breathing was maintained. Trials for tracheal intubation failed whenever using a standard laryngoscope, a bronchofiberscope, a laryngeal mask airway or an intubating laryngeal mask airway. Resecting the epiglottic elevating bar of an intubating laryngeal mask airway enabled fiberoptic tracheal intubation. No symptom suggesting malignant hyperthermia developed.

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