title: Safe duration of postoperative monitoring for malignant hyperthermia patients administered non-triggering anaesthesia: an update.
abstract: The postoperative care of malignant hyperthermia (MH) patients is subject to international variation, with a paucity of data in the literature to guide management. Over a series of three studies, our aim was to evaluate whether MH-susceptible patients (and relatives who had not yet been investigated), who had received a non-triggering anaesthetic, could be managed in the same way as the standard surgical population. Following a retrospective study, 206 anaesthetics were administered in a prospective second study to MH-susceptible/related individuals who were monitored for a minimum of one hour in the post anaesthesia care unit and a further 90 minutes in a step-down facility. No problems relating to MH were encountered. The postoperative monitoring time was subsequently changed and, in a third study, patients were managed no differently from standard surgical patients. One hundred and twenty-five anaesthetics were administered with no evidence of problems. This data shows that standard postoperative monitoring times are safe and appropriate in MH-susceptible patients.
authors.affiliation: Department of Anaesthesia, Hutt Hospital, Lower Hutt, New Zealand.
authors.forename: C
authors.initials: C
authors.lastname: Barnes
authors.affiliation: Institute of Fundamental Sciences, Massey University, Palmerston North, New Zealand.
authors.forename: K M
authors.initials: KM
authors.lastname: Stowell
authors.affiliation: Department of Anaesthesia and Intensive Care, Palmerston North Hospital, Palmerston North, New Zealand.
authors.forename: T
authors.initials: T
authors.lastname: Bulger
authors.affiliation: Department of Anaesthesia and Pain Medicine, Wellington Regional Hospital, Wellington, New Zealand.
authors.forename: E
authors.initials: E
authors.lastname: Langton
authors.affiliation: Department of Anaesthesia and Intensive Care, Palmerston North Hospital, Palmerston North, New Zealand.
authors.forename: N
authors.initials: N
authors.lastname: Pollock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008305:Malignant Hyperthermia / Q000175:diagnosis*; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods* / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: MH clinical grading scale; PACU; malignant hyperthermia; non-triggering anaesthetic; ryanodine receptor; stress; temperature monitoring