Which anesthetics and muscle relaxants can trigger malignant hyperthermia in susceptible people?

In susceptible individuals, malignant hyperthermia can be triggered by exposure to specific anesthetic agents and muscle relaxants.1

The primary agents associated with this potentially lethal condition include:

• Anesthetic agents: Specifically, the drug halothane is a known trigger.1
• Muscle relaxants: The depolarizing neuromuscular blocking agent succinylcholine is identified as a trigger for this reaction.12

Malignant hyperthermia is a rare, often inherited condition characterized by a sudden, dangerous rise in central body temperature and muscle rigidity during or after the induction of anesthesia. The reaction is believed to stem from an abnormality in calcium chemistry within muscle fibers, where excess calcium release stimulates mitochondria to produce heat and causes the muscles to become rigid. Because this condition can be fatal, rapid intervention—including the removal of the triggering agent and cooling of the patient—is essential.12