수 주전 전신 마취 시 악성고열증을 보인 환자의 마취 재시도

Malignant hyperthermia is a subclinical myopathy, usually triggered by anesthetics and associated with a mortality rate of up to 70%, when left untreated. But with early diagnosis using capnography and with the advent of dantrolene, the mortality rate could be reduced to less than 5%, which implies the significance of early diagnosis and proper treatment. Owing to the reduced mortality rate, anesthesiolo- gists get more chancex to encounter patients with a previous history of malignant hyperthermia and knowledge to provide proper anesthetic management become essential. We present a case in which ma- lignant hyperthermia was detected in a 67 year old female patient with gastric cancer and a thyroid mass during the first operation and successfully treated with promptly initiated supportive measures based on capnography finding without dantrolene which was not available at the time and the same patient rescheduled for subsequent gastrectomy in which we chose non-triggering agents in adjunct to epidural anesthesia without provoking malignant hyperthermia. (Korean J Anesthesiol 2000; 39: 141~144)