What is the first-line treatment for malignant hyperthermia?

The first-line treatment for malignant hyperthermia is dantrolene sodium. Malignant hyperthermia is a life-threatening condition that can occur in response to certain anesthetic agents, particularly in genetically predisposed individuals. The condition is characterized by a rapid increase in body temperature and severe muscle contractions. Dantrolene works by directly affecting skeletal muscle calcium release, which mitigates the hypermetabolic state and helps restore normal muscle function.

Upon administration, dantrolene decreases muscle rigidity and lowers the elevated calcium levels within the muscle cells, thereby addressing the hyperthermic crisis. Its specific mechanism of action makes dantrolene the most effective and appropriate treatment for this condition, distinguishing it from other medications not indicated for this emergency.

While benzodiazepines, propofol, and fentanyl have their respective roles in anesthesia and sedation, they do not target the underlying pathophysiology of malignant hyperthermia. Consequently, they would not alleviate the symptoms or correct the metabolic disturbances associated with the condition. Thus, dantrolene’s unique properties make it the cornerstone of treatment for malignant hyperthermia.