What is malignant hyperthermia and which agents trigger it?

What is malignant hyperthermia and which agents trigger it?

• A. Volatile inhaled anesthetics and succinylcholine
• B. Nitrous oxide and propofol
• C. Local anesthetics with vasoconstrictors
• D. Opioids and benzodiazepines

Answer: (A)

Malignant hyperthermia is a dangerous, inherited reaction of skeletal muscle to certain anesthesia drugs, caused by abnormal calcium handling inside muscle cells. In susceptible people, triggering agents cause a rapid and massive release of calcium from the sarcoplasmic reticulum, leading to uncontrolled muscle contraction and a hypermetabolic state. This drives a surge in heat and carbon dioxide production, acidosis, tachycardia, muscle rigidity, and can progress to rhabdomyolysis and dangerous electrolyte disturbances if not treated promptly. The classic triggers are volatile inhaled anesthetics (such as sevoflurane, isoflurane, and desflurane) and the depolarizing neuromuscular blocker succinylcholine. These agents are known to provoke the abnormal calcium release in susceptible individuals. Agents that are not triggers include nitrous oxide and propofol, local anesthetics with vasoconstrictors, and opioids with benzodiazepines. They do not typically induce malignant hyperthermia, though anesthesia plans should always be individualized based on the patient’s history and risk.

Malignant hyperthermia is a dangerous, inherited reaction of skeletal muscle to certain anesthesia drugs, caused by abnormal calcium handling inside muscle cells. In susceptible people, triggering agents cause a rapid and massive release of calcium from the sarcoplasmic reticulum, leading to uncontrolled muscle contraction and a hypermetabolic state. This drives a surge in heat and carbon dioxide production, acidosis, tachycardia, muscle rigidity, and can progress to rhabdomyolysis and dangerous electrolyte disturbances if not treated promptly.

The classic triggers are volatile inhaled anesthetics (such as sevoflurane, isoflurane, and desflurane) and the depolarizing neuromuscular blocker succinylcholine. These agents are known to provoke the abnormal calcium release in susceptible individuals.

Agents that are not triggers include nitrous oxide and propofol, local anesthetics with vasoconstrictors, and opioids with benzodiazepines. They do not typically induce malignant hyperthermia, though anesthesia plans should always be individualized based on the patient’s history and risk.