Nontriggering anesthetics have been shown to be safe for MH-affected individuals, and dantrolene pretreatment is no longer recommended for routine prophylaxis. MH-prevention in the undiagnosed surgical population, however, is less certain and requires familiarity with the epidemiology of this condition, carefully directed preoperative questioning and a high index of suspicion for unusual anesthetic events that might represent early or atypical MH reactions.
Most cases occur in children and young adults.
Males are more frequently affected than females, although this may be related to other demographic factors such as the incidence of emergency surgery in this group. Complicating the ability to predict accurately even further, approximately 50 percent of MH-susceptible individuals have had a previous triggering anesthetic without developing a clinically diagnosed episode . In the past, less sophisticated intraoperative physiologic monitoring may have resulted in mild clinical MH episodes that were not diagnosed. The infrequent occurrence of acute MH in neonates is an interesting observation that also has been reported in the swine model. The mechanism for this age-related difference in sensitivity is not understood.