7 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 7
If your facility solely administers conscious sedation or local
anesthesia rather than the volatile anesthetics that might trigger
malignant hyperthermia, do you still need to stock dantrolene to
treat an MH reaction? Better to be safe than sorry, says anesthe-
siologist Charles B. Watson, MD, FCCM, a consultant for the
Malignant Hyperthermia Association of the United States
(MHAUS) hotline.
Don't overlook succinylcholine. The potentially life-saving mus-
cle relaxant used to treat upper airway obstruction can also trig-
ger MH. "When we take away the protective reflexes with drugs
like propofol, we sometimes lose the airway," says Dr. Watson.
To treat an MH
episode, an
initial dose of dantro-
lene at 2.5 mg/kg is
recommended, with a
suggested upper limit
of 10 mg/kg. If a
patient of average
weight (about 70 kg)
were to require
dantrolene at the
upper dosing limit,
then you'd need at
least 700 mg of
dantrolene.
MHAUS recommends
SAFE THAN SORRY
Do All Facilities Need to Stock Dantrolene?
Manufacturer US WorldMeds
Par
Pharmaceutical
Eagle
Pharmaceuticals
Dantrolene
dose per vial
20 mg 20 mg 250 mg
Number of vials
for initial dose*
8 vials (520 ml) 8 vials (560 ml) 1 vial (5 mL)
Water to
reconstitute 1 vial
60 mL 60 mL 5 mL
Vials required
to stock
36 36 3
Price
$2,500 $2,340 $7,500
Shelf life
3 years 3 years 2 years
Revonto Dantrium Ryanodex
How the 3 MH Antidotes Stack Up
* Assumes a 143-lb. person at 2.5 mg/kg
