{
  "abstract": "The coexistence of mast cell activation syndrome (MCAS) and malignant hyperthermia (MH) presents a significant perioperative challenge due to combined risks of anaphylaxis and anaesthesia-related hypermetabolic crisis. We describe the successful anaesthetic management of a man in his 60 s with confirmed MCAS and a strong family history of MH who underwent excision of multiple malignant cutaneous lesions. A structured perioperative strategy incorporating immunological optimisation with omalizumab, strict trigger avoidance, dexmedetomidine and remifentanil procedural sedation, prophylactic corticosteroids and a controlled low-dose adrenaline infusion enabled safe completion of surgery without complication. In the absence of tolerated local anaesthetic agents, dilute adrenaline infiltration was used as an adjunct to improve procedural tolerability. This case highlights the importance of multidisciplinary planning and individualised perioperative strategy in patients with high-risk perioperative profiles.",
  "abstract_shown": true,
  "affiliations": [
    "Peter MacCallum Department of Oncology The University of Melbourne Melbourne 3010 Victoria Australia unimelb.edu.au.",
    "Department of Plastic & Reconstructive Surgery Peter MacCallum Cancer Centre Melbourne 3000 Victoria Australia petermac.org.",
    "Department of Anaesthesia Perioperative and Pain Medicine Peter MacCallum Cancer Centre Melbourne 3000 Victoria Australia petermac.org.",
    "Department of Anaesthesia Perioperative and Pain Medicine Monash Health Clayton 3168 Victoria Australia monashhealth.org.",
    "Department of Critical Care The University of Melbourne Melbourne 3010 Victoria Australia unimelb.edu.au.",
    "Department of Surgery Monash University, Clayton Melbourne 3800 Australia."
  ],
  "article_type": "case study",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Peter Francis Gearing",
      "orcid": "0000-0001-9636-608X"
    },
    {
      "affs": [
        2
      ],
      "name": "Thomas Nack"
    },
    {
      "affs": [
        2
      ],
      "name": "Dinuk Liyanage",
      "orcid": "0009-0009-7402-2433"
    },
    {
      "affs": [
        2,
        3,
        4,
        5
      ],
      "name": "Walston Reginald Martis",
      "orcid": "0009-0003-3720-914X"
    },
    {
      "affs": [
        1
      ],
      "name": "Michael Findlay",
      "orcid": "0000-0002-1163-1815"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9bp4bchfbq7sb.bib",
  "cited_by": 0,
  "doi": "10.1155/cria/2750619",
  "fulltext_url": "https://europepmc.org/articles/PMC13714451",
  "id": "9bp4bchfbq7sb",
  "issns": [
    "2090-6382",
    "2090-6390"
  ],
  "landing_url": "https://europepmc.org/article/MED/42953382",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2703|Anesthesia and Sedative Agents"
    ]
  ],
  "openalex": "W7224082729",
  "pdf_url": "https://europepmc.org/articles/PMC13714451?pdf=render",
  "pmcid": "PMC13714451",
  "pmid": "42953382",
  "published": "2026-10-27",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/9bp4bchfbq7sb.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:40Z",
      "native_id": "MED:42953382",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42953382"
    },
    {
      "first_seen": "2026-11-01T12:21:56Z",
      "native_id": "PMC13714451",
      "source": "pmc",
      "url": "https://doi.org/10.1155/cria/2750619"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2703|Anesthesia and Sedative Agents",
      "subfield": "surgery"
    }
  ],
  "title": "Perioperative Management of Coexisting Mast Cell Activation Syndrome and Malignant Hyperthermia Susceptibility: A Case Report and Novel Approach to Local Analgesia.",
  "title_text": "Perioperative Management of Coexisting Mast Cell Activation Syndrome and Malignant Hyperthermia Susceptibility: A Case Report and Novel Approach to Local Analgesia.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:56Z",
  "url": "https://research.draconitic.com/paper/9bp4bchfbq7sb",
  "venue": "Case reports in anesthesiology",
  "versions": []
}