Anaes Cases · Malignant hyperthermia
The patient with a family history of malignant hyperthermia
The anticipated-MH long case — taking the family history seriously, the interim trigger-free technique (TIVA, vapour-free machine, no sux, dantrolene available), and arranging the contracture test / genetic work-up. Built on the EMHG susceptible-patient guideline.
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Prompt
A 28-year-old woman presents for elective laparoscopic cholecystectomy. Her father had a near-fatal reaction under general anaesthesia and has since been told he is malignant-hyperthermia-susceptible. Discuss your assessment and your anaesthetic plan.
Presentation
A 28-year-old otherwise-well woman is booked for an elective laparoscopic cholecystectomy. At preoperative assessment she volunteers that her father suffered a life-threatening reaction under general anaesthesia many years ago — "they said it was malignant hyperthermia" — and that he now carries a warning card. She has never herself been investigated. She is anxious but well, with no comorbidity and a normal baseline examination.
[10]References2ShowHide
- [10]Rüffert H, Bastian B, Bendixen D, et al. Consensus guidelines on perioperative management of malignant hyperthermia suspected or susceptible patients from the European Malignant Hyperthermia Group. British Journal of Anaesthesia, 2021.PMID 33131754
- [11]Rüffert H, Gillies R, Hopkins PM, et al. European Malignant Hyperthermia Group 2025 guidelines for the investigation of malignant hyperthermia susceptibility. British Journal of Anaesthesia, 2026.PMID 41478797