Malignant Hyperthermia-Susceptible Adult Patient and Ambulatory Surgery Center: Society for Ambulatory Anesthesia and Ambulatory Surgical Care Committee of the American Society of Anesthesiologists Position Statement

Anesth Analg. 2019 Aug;129(2):347-349. doi: 10.1213/ANE.0000000000004257.


This document represents a joint effort of the Society for Ambulatory Anesthesia (SAMBA) and the Ambulatory Surgical Care Committee of the American Society of Anesthesiologists (ASA) concerning the safe anesthetic care of adult malignant hyperthermia (MH)-susceptible patients in a free-standing ambulatory surgery center (ASC). Adult MH-susceptible patients can safely undergo a procedure in a free-standing ASC assuming that proper precautions for preventing, identifying, and managing MH are taken. The administration of preoperative prophylaxis with dantrolene is not indicated in MH-susceptible patients scheduled for elective surgery. There is no evidence to recommend an extended stay in the ASC, and the patient may be discharged when the usual discharge criteria for outpatient surgery are met. Survival from an MH crisis in an ASC setting requires early recognition, prompt treatment, and timely transfer to a center with critical care capabilities.

Publication types

  • Practice Guideline

MeSH terms

  • Ambulatory Surgical Procedures / adverse effects
  • Ambulatory Surgical Procedures / standards*
  • Anesthesia / adverse effects
  • Anesthesia / standards*
  • Dantrolene / administration & dosage
  • Early Diagnosis
  • Hospitalization*
  • Humans
  • Malignant Hyperthermia / diagnosis
  • Malignant Hyperthermia / etiology
  • Malignant Hyperthermia / therapy*
  • Muscle Relaxants, Central / administration & dosage
  • Patient Transfer / standards
  • Risk Assessment
  • Risk Factors
  • Surgicenters / standards*
  • Treatment Outcome


  • Muscle Relaxants, Central
  • Dantrolene