Causes of Increased Plasma Creatine Kinase Activity after Surgery

To determine whether drug reactions might play a role in postoperatively increased plasma enzyme activity, we measured creatine kinase (CK), and ornithine carbamoyl transferase (OCT) activities immediately before and on the 1st, 4th, and 8th day after 343 elective surgical procedures performed on 327 patients who had received various drugs pre-operatively. We saw no overt clinical evidence of muscle damage, but plasma CK activity was significantly increased on the first postoperative day. Plasma OCT activity was not significantly altered. We found no relationship between prior drug exposure and in creased CK activity, but the administration of general rather than regional anesthesia and the duration of anesthesia during surgery were closely related to increased CK activity. Halothane or succinylcholine administration during operation was also associated with a significant increase in CK activity in subjects whose pre-operative CK activity was normal. In contrast, subjects with increased pre-operative CK activities did not show this response to halothane or succinylcholine.