Malignant Hyperthermia: Pre- and Post-Dantrolene

Abstract

Malignant hyperthermia (MH) is a rare myogenic hypermetabolic syndrome that is associated with certain commonly used anesthetic agents and muscle relaxants. Although the first case of MH was noted over 60 years ago, the syndrome was not described in the literature until 1960 by Denborough and Lovell.¹ Since then, the pathophysiology and etiology have been studied and reviewed extensively. Treatment of MH before 1975 was primarily oriented toward correction of physiologic derangements. Mortality rates were characteristically 60% to 80%. Dantrolene sodium was added to the treatment protocol following successful use in MH-susceptible (MHS) pigs by Harrison² in 1975 and later that same year in MHS humans by Britt.⁸ Since its approval by the FDA in 1979 for use in the treatment of MH, dantrolene has led to a dramatic decrease in morbidity and mortality caused by MH. This survey evaluates the pre-dantrolene and post-dantrolene experience with MH in the greater Kansas City area.