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

Abstract

Malignant hyperthermia (MH) is a life-threatening condition in which genetically predisposed individuals develop a hypermetabolic reaction to inhalational anesthetics or succinylcholine. Due to the rarity of the disease and ethical limitations, there are no intervention trials to inform the optimal perioperative management of patients susceptible to MH.  These guidelines aim to group the available knowledge on the perioperative management of patients susceptible to MH and the preparation of anesthesia machines. The guidelines were developed by members of the European Malignant Hyperthermia Group and are based on evaluation of the available literature and a formal consensus process. The most important recommendation is that susceptible patients should receive trigger-free anesthesia, prophylactic administration of dantrolene should be avoided, intraoperative and postoperative follow-up should not be affected by susceptibility to the condition, and patients may be anesthetized in an outpatient setting.