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The problem of masseter rigidity

Created: 16/11/2004
 

Increased masseter tone occurs in 0.3% of those under halothane anaesthesia given succinylcholine, but only 50% of those referred have positive muscle biopsy.

There are at least three degrees

- Poor relaxation - "common" response
- Mild increase in tone - can intubate and ventilate
- Jaws of steel - can't intubate

Suggestions

- Check nerve stimulator to see if relaxant dose is adequate
- Check muscle tone in extremities
- Clinical picture does not prospectively predict susceptibility

Management of spasm is controversial. Termination of anaesthesia, treatment with dantrolene, proceeding with caution or referral for muscle biopsy have all been recommended.

Reference

[i] Jaw stiffness - an ill understood condition.
Saddler JM
Br J Anaesth 1991; 67: 515-16


ArticleDate:20041116
SiteSection: Article
 
   
    
                                            
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