We anesthesized a patient susceptible to malignant hyperthermia (MH) t
hree different times by epidural anesthesia with different types of lo
cal anesthetics. His skinned fiber test showed a marked acceleration o
f calcium (Ca2+)-induced Ca2+ release (CICR). When ester type local an
esthetic was used for ankle contracture repair, MH signs appeared foll
owing the release of the tourniquet. CICR test is reliable for diagnos
ing different types of MH.