Perioperative Malignant Hyperthermia

Abstract Malignant Hyperthermia (MH) is a rare inherited disorder in which exposure to triggering agents such as volatile anesthetics or depolarizing neuromuscular blockers causes a hypermetabolic reaction leading to patient fatality. MH susceptible patients have a genetic mutation on the ryanodine one receptor (RYR1) in skeletal muscle, allowing uninhibited calcium release (Smith, Tranovich, & Ebraheim, 2018). Increases in free calcium result in an uncontrollable sustained muscle contraction through the excitation-contraction coupling of myosin and actin. Sustained muscle contraction rapidly consumes adenosine triphosphate stores and stimulates conversion to lactate producing anaerobic metabolism (Smith et al., 2018). Immediate recognition and treatment of MH are warranted to prevent patient fatalities. It is imperative that nurse anesthetists and all perioperative staff understand and can recognize the manifestations and treatment of MH. As a collaborative and well-versed team, perioperative staff can decrease the number of patient fatalities due to Malignant Hyperthermia