Introduction

When malignant hyperthermia was first described the mortality was 70 to 80 per cent, but this has now fallen dramatically to less than 10 per cent worldwide; in the United Kingdom there have been only three deaths in the last 5 years. This vast improvement has been brought about by three factors:

1. increased awareness and understanding of malignant hyperthermia by anesthetists;

2. better intraoperative monitoring facilities, particularly capnography and pulse oximetry;

3. the availability of an intravenous formulation of dantrolene.

The first two factors lead to the early diagnosis of malignant hyperthermia at a stage when prompt treatment is usually successful. Late recognition of malignant hyperthermia will probably result in the death of the patient despite treatment with dantrolene.

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