No response to trigger agents in a malignant hyperthermia‐susceptible patient

Abstract

Malignant hyperthermia susceptibility is an inherited disorder, where a life-threatening condition can result from exposure to a trigger agent or agents. Succinylcholine and volatile anaesthetic agents are well established to be trigger agents in anaesthetic practice. We describe a case of a previously investigated malignant hyperthermia-susceptible patient who did not declare his status and was exposed to both succinylcholine and isoflurane, without any detectable reaction. Possible explanations for the lack of reaction include a subnormal temperature when exposed to isoflurane, and a significant interval between exposure to succinylcholine and isoflurane. Absence of a reaction to trigger agents on this occasion is not thought to indicate an incorrect diagnosis and labelling.

Malignant Hyperthermia in Liver Transplantation

“…It must be emphasized that uneventful previous anesthetics (even more than once) with MH-triggering agents do not preclude the occurrence of MH in future exposures 56,98 .…”