Articles  |   June 2015
SEE Question
Article Information
Neuromuscular Diseases and Drugs / Pharmacology / Technology / Equipment / Monitoring / Articles
Articles   |   June 2015
SEE Question
ASA Monitor 06 2015, Vol.79, 69.
ASA Monitor 06 2015, Vol.79, 69.
Which statement best describes current recommendations regarding preparation for and management of malignant hyperthermia (MH) in ambulatory surgical centers?
MH is a rare but life-threatening condition typically brought on by volatile anesthetics and succinylcholine used in general anesthesia. Onset typically is recognized while the patient is receiving general anesthesia, although occasionally signs may not present until the patient has reached the recovery area. The frequency of MH in patients undergoing procedures at ambulatory surgical centers is estimated to be 0.31 per 100,000 procedures; the frequency for inpatient procedures is estimated at 1 in 100,000.
Since the introduction of dantrolene as treatment for MH, mortality has dropped from a 70 percent to 80 percent range to less than 5 percent currently. Improvements in intraoperative monitoring also likely play a role. MH can occur at any time following the administration of a triggering agent, even a short exposure. Early treatment with dantrolene is critical, and MH patients with delayed or inadequate treatment (e.g., transferred to a tertiary care center from another health care facility before beginning treatment or not enough dantrolene on hand) have a higher mortality rate, which may be due to inadequate or absent dosing of dantrolene during the acute phase of the event. However, maintaining a supply of dantrolene can be expensive, and a recent study examined the cost-effectiveness of stocking 36 vials of dantrolene at every ambulatory surgical center as recommended by the Malignant Hyperthermia Association of the United States (MHAUS).
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