Postoperative changes in serum creatine kinase in paediatric orthopaedic patients with preoperative hyperCKaemia: review of three cases

  • Shinichiro Kira Beppu Developmental Medicine & Rehabilitation Center
  • Keisuke Shiihara Oita University
  • Kentaro Okuda Oita University
Keywords: postoperative change, creatine kinase, preoperative hyperCKemia, malignant hyperthermia, rhabdomyolysis

Abstract

An elevated serum creatine kinase (CK) level is commonly known as hyperCKaemia, and anaesthesiologists must take into account the potential susceptibility of hyperCKaemia patients to develop malignant hyperthermia during general anaesthesia as well as acute onset of rhabdomyolysis postoperatively. Three paediatric patients with hyperCKaemia were scheduled for orthopaedic surgery. With the consent of their parents, their CK changes were monitored for seven days postoperatively to detect rhabdomyolysis. The results showed that the postoperative CK change patterns were almost the same as those for patients whose CK levels were within reference range. Maximum CK levels tended to be higher in these patients than in the CK reference-range patients studied previously, although the reason remains unclear. This experience and previous studies suggest that measuring CK levels at least on postoperative days 1 and 2 might be better for detecting early signs of rhabdomyolysis, even in paediatric patients with hyperCKaemia.

Author Biographies

Shinichiro Kira, Beppu Developmental Medicine & Rehabilitation Center

Division of Anaesthesia, Medical Department, Beppu Developmental Medicine and Rehabilitation Center, Beppu, Japan 

Keisuke Shiihara, Oita University

Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Oita University, Yufu, Japan

Kentaro Okuda, Oita University

Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Oita University, Yufu, Japan

Published
2019-04-25
Section
Letters to the Editor