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Information for Patients
This section of the website is designed to educate patients about malignant hyperthermia and its diagnosis, treatment and management. Click on an item below to read more.
Malignant Hyperthermia Triggers
Scientists believe the anesthetic agents that stimulate an MH crisis have been identified. These agents include volatile gaseous inhalation anesthetics and the muscle relaxant succinylcholine. Many drugs have been determined not to trigger MH as well. Barbiturates, narcotics (opioids), tranquilizers, local anesthetics, intravenous anesthetic induction agents and the inhaled gas nitrous oxide (NO) will not trigger MH, nor will muscle paralyzing agents. Furthermore, it is clear that the vast majority of prescription and non-prescription drugs will not trigger MH.
Despite having knowledge of which agents will and will not trigger MH, the reasons why they trigger MH are still a mystery. Not everyone who has MH develops an episode each time a triggering agent is given to him or her. Tragedies have occurred even after multiple prior uneventful surgeries. Thus, even individuals who have had surgery without complications before cannot be certain they are not at risk. In some rare cases environmental stressors such as heat and exercise may trigger an MH episode.
MH Precautions
With proper preparedness by both the MH-susceptible person and the OR team, a negative outcome can, in most cases, be avoided when MH occurs during anesthesia. For medical professionals, this includes being familiar with MH testing protocols, trigger agents, symptoms and proper treatment procedures. MH susceptible individuals must be aware of triggers and assure they share their complete medical history with their anesthesia care provider. It is highly recommended that MH patients always wear a medical ID tag and ensure their hospital or ambulatory center stocks a full 36-vial supply of unexpired dantrolene sodium for injection.
