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Updated: Jun 1, 2026
07:56
Protocol for Long Duration Whole Body Hyperthermia in Mice
Published on: August 25, 2012
Malignant hyperthermia: pharmacology of triggering
1Section of Translational Anaesthetic and Surgical Sciences, Leeds Institute of Molecular Medicine, University of Leeds, UK. p.m.hopkins@leeds.ac.uk
British Journal of Anaesthesia
|June 1, 2011
Summary
Malignant hyperthermia (MH) is a serious reaction to certain anesthetic drugs. Modern inhalation agents can trigger MH, sometimes with delayed onset, and understanding drug triggers is crucial for patient safety.
Area of Science:
- Anesthesiology
- Pharmacology
- Medical Genetics
Background:
- Malignant hyperthermia (MH) is a pharmacogenetic disorder affecting skeletal muscle calcium regulation.
- Numerous drugs have been identified as potential triggers for MH over the past 50 years.
- Understanding drug-induced MH is critical for patient safety during anesthesia.
Purpose of the Study:
- To review potent inhalation agents as principal triggers of malignant hyperthermia.
- To discuss evidence regarding modern anesthetic agents and their association with MH reactions.
- To explore the role of other drugs and calcium regulation mechanisms in MH.
Main Methods:
- Literature review of drugs implicated in malignant hyperthermia.
- Analysis of evidence for anesthetic agents as MH triggers.
- Discussion of calcium regulation pathways in skeletal muscle relevant to MH.
Main Results:
- Potent inhalation agents, including modern agents like desflurane, sevoflurane, and isoflurane, are principal triggers of MH.
- MH reactions can have delayed onset, even hours into anesthesia.
- Drug-induced MH appears to be dose-dependent, though the minimum triggering dose remains unknown.
- Non-depolarizing neuromuscular blocking drugs may offer protection against MH.
- Excitation-coupled calcium entry and store-operated calcium entry are implicated in MH mechanisms.
Conclusions:
- Modern inhalation anesthetics can trigger malignant hyperthermia, necessitating careful machine preparation for at-risk patients.
- Succinylcholine's role as an MH trigger is debated, but it enhances responses to inhalation agents.
- Further research into drug triggers and calcium regulation pathways is essential for managing MH.
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