Rhabdomyolysis
Rhabdomyolysis may occur during an MH episode or trismus, but
milder forms occur more often than realized. In a study of 11 normal children, those
given succinylcholine had a serum myoglobin level of 1187 ± 615
ng/mL, in contrast to 30±9 ng/mL in those
not given succinylcholine.[94]
Myoglobinuria with
rhabdomyolysis can occur in various muscle disorders and without exposure to succinylcholine.
[92]
Because of the virtual identity of myoglobin
and hemoglobin, myoglobinuria can be misdiagnosed as hemolysis during MH. Any unusual
anesthetic incident—muscle response, arrhythmia, trismus, or fever—should
prompt examination of urine color and plasma electrolytes, especially potassium.
