Healthcare facilities that use succinylcholine should always stock dantrolene to treat potential episodes of malignant hyperthermia (MH), according to research in the latest Anesthesia & Analgesia.

Researchers used registry data and estimated the frequency of administration of succinylcholine during anesthesia to determine the magnitude of its relative risk, and found that incidence of MH was much higher when succyinylcholine was used. However, they note that the incidence of MH was statistically significant any time volatile anesthetic agents were used alone, as well.

Although the results do not provide "insight into the triggering mechanism for MH (i.e., succinylcholine could in isolation have an extremely low incidence of inducing MH, yet markedly increase the risk when administered in combination with volatile anesthetics)," the authors conclude that the availability of dantrolene at facilities that administer succinylcholine "satisfies cost-utility norms even for sites with as few as 1 anesthetic per workday, based on the overall incidence of MH per anesthetic."

Stephanie Wasek