Case 46: Rapid Increase in Body Temperature After Induction of General Anesthesia

Abstract

A 14-month-old boy is scheduled to undergo repair of a cranial dysostosis. His history is unremarkable. There is evidence of increased intracranial pressure, but no hydrocephalus. The patient has had no previous anesthesia/surgery, and his family history is negative for anesthesia-related complications. He takes no medication and has no drug allergies. He is classified as American Society of Anesthesiologists physical status I (ASA 1) with a class 2 airway. Monitors include pulse oximetry, electrocardiogram (ECG), liquid crystal temperature indicator (LCTI), noninvasive blood pressure (BP) cuff, and precardial stethoscope. The child is kept warm with two heating lamps. General anesthesia is induced via face mask using sevoflurane 1–4% in 100% oxygen. After the child is asleep, the LCTI on the forehead is seen to increase quickly to 41.0°C from 36.5°C. All other parameters are within normal limits. You are concerned and alert the surgeons and call for the malignant hyperpyrexia cart.