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Malignant Hyperthermia–Susceptible Adult Patient and Ambulatory Surgery Center: Society for Ambulatory Anesthesia and Ambulatory Surgical Care Committee of the American Society of Anesthesiologists Position Statement

Urman, Richard D. MD, MBA*; Rajan, Niraja MD; Belani, Kumar MBBS, MS; Gayer, Steven MD, MBA§; Joshi, Girish P. MBBS, MD, FFARCSI

doi: 10.1213/ANE.0000000000004257
Ambulatory Anesthesiology
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This document represents a joint effort of the Society for Ambulatory Anesthesia (SAMBA) and the Ambulatory Surgical Care Committee of the American Society of Anesthesiologists (ASA) concerning the safe anesthetic care of adult malignant hyperthermia (MH)-susceptible patients in a free-standing ambulatory surgery center (ASC). Adult MH-susceptible patients can safely undergo a procedure in a free-standing ASC assuming that proper precautions for preventing, identifying, and managing MH are taken. The administration of preoperative prophylaxis with dantrolene is not indicated in MH-susceptible patients scheduled for elective surgery. There is no evidence to recommend an extended stay in the ASC, and the patient may be discharged when the usual discharge criteria for outpatient surgery are met. Survival from an MH crisis in an ASC setting requires early recognition, prompt treatment, and timely transfer to a center with critical care capabilities.

From the *Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts

Department of Anesthesiology and Perioperative Medicine, Penn State Hershey Medical Center/Penn State Health, Hershey, Pennsylvania

Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota

§Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Health System, Miami, Florida

Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.

Published ahead of print 1 May 2019.

Accepted for publication May 1, 2019.

Funding: None.

Conflicts of Interest: See Disclosures at the end of the article.

Reprints will not be available from the authors.

Address correspondence to Girish P. Joshi, MB, BS, MD, FFARCSI, Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390. Address e-mail to girish.joshi@utsouthwestern.edu.

Copyright © 2019 International Anesthesia Research Society
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