ABSTRACT
All volatile anesthetic agents and depolariz ing muscle relaxants may trigger an uncom mon, but life-threatening, sustained skeletal muscle hypermetabolism called malignant hyperthermia (MH) in genetically suscep tible individuals. Clinical signs of MH are variable and may include tachycardia, tachypnea, hypercarbia, respiratory aci dosis, metabolic acidosis, masseter muscle rigidity, generalized muscular rigidity, myo globinuria, rhabdomyolysis, arrhythmias, cyanosis, skin mottling, hyperkalemia, diaphoresis, rapid temperature elevation, hemodynamic instability, and coagulopathy (1-3). Acute MH events strike individuals who are usually healthy and who display no signs of disease. Abnormal susceptibility to MH-triggering anesthetic agents is most frequently inherited in an autosomal domi nant fashion with variable penetrance. This chapter focuses on methods for diagnosing, treating, and predicting susceptibility to this anesthetic-induced toxicity.
