Postoperative malignant hyperthermia episodes in patients who received 'safe' anaesthetics

Three cases of postoperative malignant hyperthermia (MH) episodes, after what was considered to be a "safe" anaesthetic, are described. In each case the temperature rose in a delayed fashion after an uneventful anaesthetic. Treatment included intravenous dantrolene, surface cooling and ventilation with 100 per cent oxygen. Stress in the postoperative period may have been the triggering factor responsible for these reactions. Patients should be monitored well into the postoperative period as MH episodes may occur long after surgery is completed. If stress represents a significant triggering mechanism then no anaesthetic technique can be considered entirely safe.