2 6 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E J U LY 2 0 1 5
trose, calcium chloride or calcium gluconate, regular insulin, and refrigerated
cold saline solution for IV cooling. These drugs are used to treat the deadly con-
sequences of MH, including high potassium levels that can stop the patient's
heart. Stock charcoal filters for your anesthesia machine, as well as basic sup-
plies such as syringes, IV catheters, nasogastric tubes and Toomey irrigation
syringes. Also have available basic nursing necessities and lab testing supplies
for blood and urine analysis. For a complete list, visit mhaus.org.
3. Can MH-susceptible
patients undergo surgery at an ASC?
Yes. In fact, these cases are often safer than when you don't know if the patient
is MH-susceptible, since you can plan accordingly.
Your anesthesia providers should anesthetize the patient without using the
volatile gases that can trigger an episode: isoflurane, sevoflurane and desflu-
rane. Most providers use IV propofol as an alternative. Providers will also
want to avoid the use of succinylcholine, because that is also a known trigger.
Before surgery begins on an MH patient, the anesthesia provider should insert
charcoal filters into the anesthesia machine's breathing circuit to purge it of
residual anesthetic gases.
If an MH-susceptible patient successfully undergoes the surgery using non-
triggering anesthetics, they may be sent home using your normal discharge
criteria. While it may seem intimidating, known MH-susceptible patients can
safely undergo surgery and general anesthesia in any type of outpatient facili-
ty.
4. A patient has a high fever
in recovery. Could this be MH?
This is a common call we receive at the hotline. While MH is associated with
several different symptoms — rigid muscles, flushed skin, a spike in end-tidal