[Fatal hyperthermic crisis after premedication. Human stress syndrome or trigger effect of promethacine (author's transl)].

A case report of a fatal hyperthermic crisis after premedication and before introduction of anaesthesia is given. Based on the typical clinical course, CK isoenzyme patterns and preliminary results of familial investigation the diagnosis of malignant hyperthermia could be established. According to literature reports, psychic stress and/or phenothiazine medication may be assumed as triggering factors. Until a potential causality between malignant hyperthermia and phenothiazine medication can definitely be ruled out, their use in suspicious cases of susceptibility to malignant hyperthermia should be avoided.