Anaesthesia for MH susceptible or suspected MH
susceptible patients

The MH Unit is happy to provide advice either by telephone or letter.  IIn the referral letter to the surgeon, GPs should highlight that a patient has MH . Pre-operative assessment clinics are now almost universally available. Pre-assessment nursing staff should routinely ask patients about their own and their family’s anaesthetic histories and not rely on patients to volunteer the information – although most will. The anaesthetist should then be informed so that appropriate plans can be made in advance.

All local anaesthetic agents are safe to use and can be given in the dental surgery. A local anaesthetic technique may be the method of choice for MH patients. General anaesthesia can be safely provided avoiding the contraindicated agents suxamethonium and ALL the anaesthetic vapours using a “vapour free” anaesthetic machine. An anaesthetic machine needs to be prepared beforehand by removing the vapourisers, circuitry and soda lime, running the machine with the ventilator on a high flow of oxygen for 20-30mins and then reattaching clean circuits and fresh soda lime.

The MH unit cannot provide an emergency screening service. It is the anaesthetist’s decision whether to proceed with an MH safe technique and screen later or defer until after screening bearing in mind the facilities, urgency of the operation, co-morbidities and any additional risks an MH safe GA might pose. Prophylactic dantrolene is not required but should be available