Succinylcholine-Induced Masseter Muscle Rigidity Successfully Managed With Propofol and Laryngeal Mask Airway: A Case Report and Brief Review

Abstract

Masseter muscle rigidity following administration of succinylcholine for induction of general anesthesia is considered an early warning sign for the possibility of an episode of dreaded complication i.e., malignant hyperthermia. This report describes a case of masseter muscle rigidity encountered at the start of an emergency surgical procedure. After succinylcholine administration, laryngoscopy and intubation were not possible due to the masseter muscle spasms. This led to the use of laryngeal mask airway and propofol for the successful conclusion of the procedure with no intraoperative or postoperative complications. Later, the patient was discharged with instructions to avoid the contributing triggers in the future and recommendations of caffeine-muscle biopsy.

Succinylcholine induced Masseter spasm in a young male with frontal sinus abscess

“…The most dreaded complication is malignant hyperthermia (MH) as it can be fatal if not managed in time. 2 Succinylcholine can cause a transient increase in muscle tone preceding the muscle paralysis. In genetically susceptible individuals this increased muscle tone especially in the jaw muscles can persist, which might lead to difficultly in mouth opening, making laryngoscopy and endotracheal intubation particularly challenging.…”