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Frequently Asked Questions
Please select a question from the list below.
- What drugs trigger MH?
- What anesthetic drugs are safe?
- Should MH patients be pre-treated with Dantrolene?
- How many vials of Dantrolene should be stocked?
- How long does an MH patient need to be monitored after a non-triggering anesthetic?
- How should a patient with family history of MH be managed?
- Where should a muscle biopsy for MH take place?
What drugs trigger MH?
All the inhalation anesthetics (desflurane, sevoflurane, isoflurane, methoxyflurane halothane, enflurane) and succinylcholine (a depolarizing muscle relaxant) are considered MH triggers.
What anesthetic drugs are safe?
Barbiturates, propofol, ketamine, etomidate, benzodiazepine, nitrous oxide, all the non depolarizing muscle relaxants, and all the local anesthetics are safe.
Should MH patients be pre-treated with Dantrolene?
No. If non triggering anesthetics are used, there is no need to pre-treat with Dantrolene.
How many vials of Dantrolene should be stocked?
A minimum of 36 vials of Dantrolene should be available. The initial dose is 2.5 mg/kg with a suggested upper limit of 10 mg/kg; for a 70 kg patient this would be 36 vials.
How long does an MH patient need to be monitored after a non-triggering anesthetic?
According to MHAUS guidelines, one hour in PACU, and one hour in phase 2 PACU are sufficient for monitoring an MH patient who received a non-triggering, uneventful anesthetic. As long as a non-triggering anesthetic was used, they can be candidates for day surgery procedures.
How should a patient with family history of MH be managed?
The patient should be referred to MHIU for assessment/counseling, and possible testing. However, until his/her status is known, a trigger-free anesthetic should be administered.
Where should a muscle biopsy for MH take place?
Only centers with a standard protocol for the caffeine-halothane contracture test are eligible to perform the diagnostic muscle biopsy. Please see our list of eligible centers.
