A 12-year-old boy with a femur fracture after a motor vehicle collision undergoes operative repair. After induction of anesthesia, he develops a fever of 40degC (104degF), shaking rigors, and blood-tinged urine. Which of the following is the best treatment option?
The patient is manifesting symptoms of malignant hypehermia (fevers, rigors, and myoglobinuria), which is treated by administration of dantrolene, immediate discontinuation of offending medication (which can include succinylcholine or halothanebased inhalational anesthetics), and suppoive cooling measures. While urine alkalinization, loop diuretics, and mannitol are appropriate treatment measures for rhabdomyolysis, the underlying problem in this patient is malignant hypehermia, which, because of its associated moality of 30% in severe cases, should be treated first and foremost. Malignant hypehermia is not a manifestation of anaphylactic shock, and therefore steroids and antihistamines have no role in its treatment.
Alkalinization of the urine, administration of mannitol, and continuation with the procedure
Administration of dantrolene sodium and continuation with the procedure
Administration of dantrolene sodium and termination of the procedure
Administration of intravenous steroids and an antihistamine agent with continuation of the procedure
Preoperative assessment and monitoring in anaesthesia