Following discharge, they should be provided with an emergency telephone number to contact if problems arise. If there is a question of MH susceptibility and a biopsy has not been done, the patient should be considered susceptible and a nontriggering anesthetic technique used. In the absence of an ice machine, there should be an adequate supply of ice in the freezer or freezing compartment of a refrigerator and ability to crush it. Also saline can be placed in the blood refrigerator. Local or regional anesthesia and monitored anesthesia care are safe.
Intravenous drugs are safe, including propofol, barbiturates, benzodiazapines, etomidate.
Succinylcholine and the potent inhalational agents, halothane, enflurane, isoflurane, desflurane, sevoflurane and even agents such as ether, cyclopropane and methoxyflurane are unsafe. The drugs and supplies should be assembled in an MH kit or cart. An MH patient should be observed and monitored for three to five hours post operatively. A biopsy for MH should be performed at one of the ten US Muscle Biopsy Centers complying with a standard protocol for the caffeine-halothane contracture test. A patient who exhibits marked rigidity of the jaw muscles should not be discharged.