Anaesthesia & ICU
Malignant Hyperthermia
Recognise rising ETCO₂ + hyperthermia + masseter spasm during anaesthesia; STOP triggers, dantrolene, supportive care.
Source: AAGBI 2011; MHAUS
Step 1 of ~3
info
Recognise
Triggers: volatiles (sevoflurane, isoflurane, desflurane, halothane), suxamethonium. Early: rising ETCO₂ despite ↑ MV, masseter / generalised muscle rigidity, tachycardia, arrhythmia, sweating. Late: hyperthermia >40°C, mixed acidosis, hyperK, rhabdomyolysis, AKI, DIC, cardiac arrest. Genetic: RYR1 mutation in 50–70%.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Ketamine (Anaesthesia/Sedation) · Dissociative Anaesthetic (NMDA Receptor Antagonist)
- Morphine (IV/IM — Anaesthesia/ICU) · Strong Opioid Analgesic
- Suxamethonium (Anaesthesia/RSI) · Depolarising Neuromuscular Blocking Agent
- Rocuronium (Anaesthesia/RSI) · Non-Depolarising Neuromuscular Blocking Agent
- Fentanyl (IV — Anaesthesia/ICU) · Opioid Analgesic (Short-Acting)
- Lidocaine (IV — Anaesthesia/ICU) · Local Anaesthetic / Antiarrhythmic (Class Ib)
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Anaphylaxis Under Anaesthesia · AAGBI 2018; NAP6
- Local Anaesthetic Systemic Toxicity (LAST) · AAGBI 2010; ASRA 2017
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Postoperative Nausea & Vomiting · Society for Ambulatory Anesthesia 2020; AAGBI
- Surviving Sepsis Bundle (Adult ICU) · Surviving Sepsis Campaign 2021; NICE NG51
Decision support only. Always apply local guidelines and clinical judgement.