Dantrolene for malignant hyperthermia treatment

Besides symptomatic treatment, high-flow O2, termination/postponement of surgery, dantrolene sodium should be given at 2 mg/kg i.v. and repeated until the cardiac and respiratory systems stabilize ¹⁾.

Complications after dantrolene are common, but rarely life threatening. Unidentified factors in the surgical environment are associated with changes in the risk of complications. Fluid management, as part of the treatment of MH, has an important association with the risk of complications after dantrolene administration and should be monitored closely ²⁾.

Dantrolene sodium suspension

Mortality of MH has been significantly reduced by using the skeletal muscle relaxant dantrolene. However, pharmacological disadvantages are known. By approval of a nanocrystalline dantrolene sodium suspension (DSS), a new product enters the market. DSS is a promising substance, but clinical data are lacking up to now. Especially with regard to newer knowledge on MH and its associated clinical presentations, there might be an increasing interest on DSS.

¹⁾

Glahn KP, Ellis FR, Halsall PJ, Müller CR, Snoeck MM, Urwyler A, et al. European Malignant Hyperthermia Group.Recognizing and managing a malignant hyperthermia crisis: Guidelines from the European Malignant Hyperthermia Group. Br J Anaesth. 2010;105:417–20.

²⁾

Brandom BW, Larach MG, Chen MS, Young MC. Complications associated with the administration of dantrolene 1987 to 2006: a report from the North American Malignant Hyperthermia Registry of the Malignant Hyperthermia Association of the United States. Anesth Analg. 2011 May;112(5):1115-23. doi: 10.1213/ANE.0b013e31820b5f1f. Epub 2011 Mar 3. PubMed PMID: 21372281; PubMed Central PMCID: PMC3498049.