Consensus guidelines on perioperative management of malignant hyperthermia suspected or susceptible patients from the European Malignant Hyperthermia Group.

Malignant hyperthermia is a potentially fatal condition, in which genetically predisposed individuals develop a hypermetabolic reaction to potent inhalation anaesthetics or succinylcholine. Because of the rarity of malignant hyperthermia and ethical limitations, there is no evidence from interventional trials to inform the optimal perioperative management of patients known or suspected with malignant hyperthermia who present for surgery. Furthermore, as the concentrations of residual volatile anaesthetics that might trigger a malignant hyperthermia crisis are unknown and manufacturers' instructions differ considerably, there are uncertainties about how individual anaesthetic machines or workstations need to be prepared to avoid inadvertent exposure of susceptible patients to trigger anaesthetic drugs.

Availability of dantrolene for the management of malignant hyperthermia crises: European Malignant Hyperthermia Group guidelines.

Faced with a malignant hyperthermia crisis, the immediate access to sufficient dantrolene is essential to achieve the best possible outcome for the patient. However, malignant hyperthermia crises are rare, and there may be administrative pressures to limit the amount of dantrolene stocked or, in some countries, not to stock dantrolene at all. There are no published guidelines to support anaesthetic departments in their effort to ensure availability of sufficient dantrolene for the management of malignant hyperthermia crises.

[The investigation of malignant hyperthermia susceptibility].

The European Malignant Hyperthermia Group has published updated guidelines for the investigation of malignant hyper-thermia (MH) susceptibility. This article gives a short description of the investigation of MH susceptibility in Denmark and an introduction to the new guidelines in Danish.

[Malignant hyperthermia].

Malignant hyperthermia susceptibility is a rare pharmacogenetic muscular disorder that may lead to potentially fatal complications in routine anesthesia. Malignant hyperthermia is triggered by volatile anesthetics and succinylcholine. In this article the pathophysiology of malignant hyperthermia, its signs, symptoms and treatment as well as safe anesthetic agents for individuals susceptible to malignant hyperthermia are discussed.