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Masseter muscle rigidity: Atypical malignant hyperthermia presentation or isolated event?

Author(s): Onyeka Tonia

Journal: Saudi Journal of Anaesthesia
ISSN 1658-354X

Volume: 4;
Issue: 3;
Start page: 205;
Date: 2010;
Original page

Keywords: Atypical malignant hyperthermia | intubation | laryngoscopy | laryngeal mask airway | masseter muscle rigidity | suxamethonium

This report describes a case of masseter muscle rigidity encountered at the start of an elective gynaecological procedure. At preoperative assessment, the patient, a 41-year old woman with a previous non-eventful surgical and anesthetic history was given a Mallampati score of 3. Following suxamethonium administration, full mouth opening proved difficult. Laryngoscopy and tracheal intubation were not possible leading to the eventual use of a laryngeal mask airway and resulting in a successful anaesthetic outcome. A number of possibilities that may account for this situation as well as viable options for airway access in such cases are discussed below.
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