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British Journal of Anaesthesia, 2002, Vol. 88, No. 6 870-873
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

No response to trigger agents in a malignant hyperthermia-susceptible patient

B. A. Claxton*,1, M. H. Cross2 and P. M. Hopkins3

1Department of Anaesthesia, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, 2Department of Anaesthesia, Leeds General Infirmary, Leeds and 3Malignant Hyperthermia Unit, University of Leeds, Leeds LS1 3EX, UK*Corresponding author

Malignant hyperthermia susceptibility is an inherited disorder, where a life-threatening condition can result from exposure to a trigger agent or agents. Succinylcholine and volatile anaesthetic agents are well established to be trigger agents in anaesthetic practice. We describe a case of a previously investigated malignant hyperthermia-susceptible patient who did not declare his status and was exposed to both succinylcholine and isoflurane, without any detectable reaction. Possible explanations for the lack of reaction include a subnormal temperature when exposed to isoflurane, and a significant interval between exposure to succinylcholine and isoflurane. Absence of a reaction to trigger agents on this occasion is not thought to indicate an incorrect diagnosis and labelling.

Br J Anaesth 2002; 88: 870–3


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