Treatment of an MH Crisis

The success of management of MH depends on early diagnosis.

The principles of treatment are to remove the triggering agents and reverse the pathophysiological processes (increased intracellular calcium iron concentration) and to treat the consequences of the pathophysiological process.

An MH treatment algorithm should be prominently displayed or available in every location where general anaesthesia is administered.

Other clinical manifestations of malignant hyperthermia.

Administration of suxamethonium (succinylcholine) may reveal potential underlying MH susceptibility before the progressive hypermetabolic and hyperthermia manifestations arise.

When given suxamethonium, MH susceptible patients have a 70% chance of developing an exaggerated increase in muscle tone. This is most commonly manifested as increased tone of the jaw muscles (masseter muscle spasm) but may extend to generalised muscle rigidity.

MH susceptible patients given suxamthonium are also at risk of rhabdomyolysis: postoperative rhabdomyolysis with acute renal failure, which has been the only manifestation of MH susceptibility in some cases.