Development of a malignant hyperthermia protocol

Background Malignant Hyperthermia is a life-threatening condition triggered by exposure to certain general anaesthetics (halothane, sevoflurane, and desflurane) and depolarising muscle relaxants (suxamethonium). Malignant hyperthermia happens primarily due to mutation of the ryanodine receptor type 1 (RYR1), located on the sarcoplasmic reticulum in myocytes. This mutation leads to increase in calcium release, muscle contraction, and heat production. Dantrolene, a skeletal muscle relaxant, is the drug of choice for malignant hyperthermia because it binds to RYR1 and thereby reduces the calcium released from the sarcoplasmic reticulum.[1] Dantrolene has been shown to significantly reduce mortality when given promptly.[2,3] A hospital is recommended to keep a minimum stock of 36 dantrolene vials, which provides 720 mg of dantrolene sufficient for a 70-kg person.[4] This study investigates whether the hospitals in the region of Fraser Health Authority, Canada, have sufficient dantrolene vials in stock.