Malignant hyperthermia susceptibility: anaesthetic implications and risk stratification

QJM. 1997 Jan;90(1):13-8. doi: 10.1093/qjmed/90.1.13.

Abstract

Malignant hyperthermia (MH) is a rare autosomal dominant trait that predisposes individuals to great danger when exposed to certain anaesthetic triggering agents, such as potent volatile anaesthetics and succinylcholine. Sudden hypermetabolic reaction occurs in skeletal muscle, leading to hyperthermia and massive rhabdomyolysis. Precautions must be taken before the anaesthesia of MH-susceptible patients. No triggering agents should be administered, central body temperature and ETCO2 should be carefully monitored, and dantrolene must be immediately available. In addition, the anaesthesia machine should be carefully washed to remove traces of halogenated agents, and the use of fresh disposable anaesthetic circuits is recommended. Early diagnosis of the syndrome by alert, informed anaesthesiologists, and the immediate administration of dantrolene and other supportive measures, has reduced mortality. Patients with MH susceptibility should be instructed to alert the anaesthesiologist about their condition whenever anaesthesia is needed. Although people diagnosed with MH susceptibility should not change their lifestyle in general, military service is limited.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Anesthesia / methods*
  • Anesthesia, Obstetrical / methods
  • Cesarean Section
  • Child
  • Child, Preschool
  • Contraindications
  • Dantrolene / therapeutic use
  • Disease Susceptibility
  • Female
  • Humans
  • Malignant Hyperthermia / genetics
  • Malignant Hyperthermia / physiopathology
  • Malignant Hyperthermia / prevention & control*
  • Muscle Relaxants, Central / therapeutic use
  • Postoperative Care
  • Pregnancy
  • Premedication
  • Risk Factors

Substances

  • Muscle Relaxants, Central
  • Dantrolene