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[S1 guidelines on malignant hyperthermia : Update 2018].

F Wappler1

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|June 27, 2018
PubMed
Summary
This summary is machine-generated.

Malignant hyperthermia (MH) is more common in Germany than previously thought. Anesthesia providers need sufficient dantrolene for treating susceptible patients, especially with new formulations potentially improving outcomes.

Keywords:
Ambulatory anaesthesiaDantroleneEmergency care medicineRyanodex®Succinylcholine

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Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Malignant hyperthermia (MH) prevalence in Germany is estimated at 1:2000-1:3000.
  • Anesthesia personnel will encounter MH-susceptible patients more frequently.

Purpose of the Study:

  • To highlight the importance of dantrolene availability for MH treatment.
  • To discuss implications for outpatient anesthesia and new dantrolene formulations.

Main Methods:

  • Review of current treatment protocols for MH.
  • Discussion of dantrolene dosing and administration.
  • Consideration of new dantrolene preparations like Ryanodex®.

Main Results:

  • Initial MH treatment requires 2.5 mg/kg body weight dantrolene.
  • Further treatment up to 10 mg/kg body weight may be needed for 24 hours.
  • Adequate water for injection is crucial for dantrolene administration.

Conclusions:

  • Sufficient dantrolene stock is vital for managing MH in clinical settings.
  • Outpatient anesthesia can avoid dantrolene storage if MH triggers are strictly avoided.
  • Ryanodex®, a new dantrolene formulation, is not yet available in Germany.