Preparation of modern anesthesia workstations for malignant hyperthermia-susceptible patients: when are they really clean?

Introduction: Malignant hyperthermia (MH) is a rare, potentially fatal genetic disorder characterized by increased cellular metabolism of skeletal muscle in response to succinylcholine and certain inhalational anesthetics. The Malignant Hyperthermia Association of the United States (MHAUS) has established guidelines for the perioperative management of MH-susceptible patients to minimize their risk. These guidelines include flushing the anesthesia machine with high-flow oxygen and replacing relatively simple components of the anesthesia workstation, but are based upon data from older generation anesthesia machines in which egress of anesthetics was more rapid. We therefore sought to review studies on newer–generation anesthesia workstations to determine if the current guidelines were applicable to these devices.