What is MH?
The science and practice of Medicine have undergone a tremendous evolution and lives are saved daily. But despite this, we see unexpected, sudden deaths in healthy individuals undergoing minor surgery. This tragedy happens to patients susceptible to Malignant Hyperthermia. MH is a inherited syndrome of skeletal muscle which is undetected until exposed to certain anaesthetic agents. This then triggers a rapid cascade of cellular events that cause a very high temperature, uncontrolled muscle contraction, cell rupture that leads to multi-organ failure and death.
Is it Dangerous?
Yes it is a killer. It is the most common cause of death in healthy people receiving general anaesthesia. Even when treated, MH can still cause death, or survivors may end up with brain damage or functional impairment of their muscles, kidneys, heart or lungs.
Which anaesthetics are unsafe?
Succinylcholine which is a depolirazing muscle relaxant and all volatile inhalation anaesthetics namely:
Sevoflurane
Desflurane
Isoflurane
Enflurane
Halothane
Methoxyflurane
Which anaesthetics are safe?
All other general anaesthetic agents and all local anaesthetics are safe
Who should know about it?
You should inform your surgeon and anaesthetist the day before your surgery, as certain specific preperations should be done to make sure you receive a trigger-free safe anaesthetic. MHS patients must always be first on the theatre list with a well-flushed and prepared anaesthetic machine.
What about the dentist?
All local anaesthetics, sedatives and even laughing gas are safe. If the dentist book you for theatre for removal or dental repair you must inform anaesthetist and make sure you are first on the list.
Why should I get tested?
“Test a muscle, save a family”. If you have a diagnosis of MHS death or near-death can be prevented in you and your family. If you know it’s there you can prevent the triggers.
Can it be treated?
Prompt recognition of an unanticipated suspected MH crisis is vital towards a favorable outcome. Getting help and the MH crash cart and immediately implementing the MH action plan can save a life. If an acute episode get recognized too late even giving dantolene can not save the patient.