Malignant hyperthermia is a hypermetabolic syndrome triggered in susceptible individuals by potent inhalation agents, succinylcholine, vigorous exercise and heat. Hyperthermia may or may not be accompanied by muscle rigidity. Aggressive management, including peripheral and core cooling techniques, oxygenation, hyperventilation, hydration and control of acidosis need to be promptly initiated with dantrolene infusion.
Figure 1: All triggering agents must be eliminated. A new vaporizer-free anesthesia machine with a new open circuit is used
Figure 2: Peripheral and central cooling includes ice packs, ice cold water immersion, fanning, gastric, bladder and rectal lavage by ice cold water or saline.
Figure 3: Dantrium is the drug, which must be infused urgently. Twelve vials containing 20 mg each will be required in an adult as first dose. Two more doses may be required subsequently.
Figure 4: This 2 yrs old girl developed hyperthermia in postop recovery and was saved by inj. dantrolen
