MALIGNANT HYPERTHERMIA SUSCEPTIBILITY - ANESTHETIC IMPLICATIONS AND RISK STRATIFICATION

Malignant hyperthermia (MH) is a rare autosomal dominant trait that pr edisposes individuals to great danger when exposed to certain anaesthe tic triggering agents, such as potent volatile anaesthetics and succin ylcholine. Sudden hypermetabolic reaction occurs in skeletal muscle, l eading to hyperthermia and massive rhabdomyolysis. Precautions must be taken before the anaesthesia of MH-susceptible patients. No triggerin g agents should be administered, central body temperature and ETCO(2) should be carefully monitored, and dantrolene must be immediately avai lable. In addition, the anaesthesia machine should be carefully washed to remove traces of halogenated agents, and the use of fresh disposab le anaesthetic circuits is recommended. Early diagnosis of the syndrom e by alert, informed anaesthesiologists, and the immediate administrat ion of dantrolene and other supportive measures, has reduced mortality . Patients with MH susceptibility should be instructed to alert the an aesthesiologist about their condition whenever anaesthesia is needed. Although people diagnosed with MH susceptibility should not change the ir lifestyle in general, military service is limited.