Malignant Hyperthermia for the Nurse Anesthetist

Malignant Hyperthermia (MH) is a rare, autosomal dominant skeletal muscle disorder that can have an insidious onset in susceptible patients exposed to the triggering agents succinylcholine, halothane, desflurane, sevoflurane, and isoflurane. MH can occur in patients who have received anesthesia with these agents in the past (Nagelhout & Plaus, 2018, p 775). Patients with a family history of MH or associated skeletal muscle disorder must be treated as MH-susceptible until proven otherwise. Failure to detect an MH crisis can lead to kidney failure, profound acidosis, coagulopathies, rhabdomyolysis, cardiac dysrhythmias, cardiovascular collapse, and death (Seifert et al., 2015). It is the responsibility of the anesthetist to perform an adequate preoperative patient history evaluation to uncover possible MH susceptibility in the surgical patient. Early detection of an MH crisis and treatment with Dantrolene affords the patient with the greatest chance of survival in the intraoperative and postoperative period