Ambulatory surgery and malignant hyperthermia.

PURPOSE OF REVIEW: It is timely to review recent publications that add to our knowledge of malignant hyperthermia because we can go to the web or to newspapers and read of recent tragic malignant hyperthermia deaths.

RECENT FINDINGS: New methods were used to affirm some of the previous observations regarding the epidemiology of malignant hyperthermia, and the well known North American Malignant Hyperthermia Registry was used to describe characteristics of malignant hyperthermia deaths. Anesthesia workstations have been found to have a larger reservoir of potent inhalation anesthetics than did their predecessors. Activated charcoal can assist in cleaning these machines. Genetic diagnosis of malignant hyperthermia susceptibility can sometimes be obtained from blood specimens. Work continues to increase the sensitivity of blood-based testing of malignant hyperthermia susceptibility.

SUMMARY: Because malignant hyperthermia is potentially lethal, families should be evaluated as thoroughly as possible when an individual who claims to be malignant hyperthermia susceptible presents for elective surgery. Genetic testing may facilitate the evaluation of families with a very strong history of malignant hyperthermia. The use of activated charcoal can speed the removal of potent inhalation anesthetics from anesthesia workstations. This should facilitate the anesthetic care of malignant hyperthermia susceptible patients.