Consensus Statement of the Malignant Hyperthermia Association of the United States on Unresolved Clinical Questions Concerning the Management of Patients With Malignant Hyperthermia

Anesth Analg. 2019 Apr;128(4):652-659. doi: 10.1213/ANE.0000000000004039.


At a recent consensus conference, the Malignant Hyperthermia Association of the United States addressed 6 important and unresolved clinical questions concerning the optimal management of patients with malignant hyperthermia (MH) susceptibility or acute MH. They include: (1) How much dantrolene should be available in facilities where volatile agents are not available or administered, and succinylcholine is only stocked on site for emergency purposes? (2) What defines masseter muscle rigidity? What is its relationship to MH, and how should it be managed when it occurs? (3) What is the relationship between MH susceptibility and heat- or exercise-related rhabdomyolysis? (4) What evidence-based interventions should be recommended to alleviate hyperthermia associated with MH? (5) After treatment of acute MH, how much dantrolene should be administered and for how long? What criteria should be used to determine stopping treatment with dantrolene? (6) Can patients with a suspected personal or family history of MH be safely anesthetized before diagnostic testing? This report describes the consensus process and the outcomes for each of the foregoing unanswered clinical questions.

Publication types

  • Consensus Development Conference

MeSH terms

  • Consensus
  • Dantrolene / supply & distribution*
  • Dantrolene / therapeutic use
  • Drug Administration Schedule
  • Evidence-Based Medicine
  • Exercise
  • Humans
  • Malignant Hyperthermia / therapy*
  • Masseter Muscle / drug effects*
  • Muscle Relaxants, Central / supply & distribution
  • Muscle Relaxants, Central / therapeutic use
  • Neuromuscular Depolarizing Agents / supply & distribution
  • Neuromuscular Depolarizing Agents / therapeutic use
  • Rhabdomyolysis / complications
  • Rhabdomyolysis / therapy*
  • Societies, Medical
  • Succinylcholine / supply & distribution*
  • Succinylcholine / therapeutic use
  • Treatment Outcome
  • United States


  • Muscle Relaxants, Central
  • Neuromuscular Depolarizing Agents
  • Dantrolene
  • Succinylcholine