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To the Editor.
—We have read with interest the excellent Archives article by Dodd et al. After reading this review, one is tempted to believe that the triggering of malignant hyperthermia can be prevented by use of a "safe" anesthetic agent.We, however, have had the disconcerting experience of seeing a phenomenon, to our knowledge not previously reported—development of an episode of malignant hyperthermia after oral pretreatment with dantrolene sodium and administration of an anesthetic agent suggested by most to be nontriggering. Details of this ophthalmic case can be found in Anesthesiology (1981;54:1-2, 73-75). This first reported case of such an occurrence stresses the continued vigilance one must maintain despite following the usual and accepted protocol for patients suspected of having malignant hyperthermia.Other details associated with malignant hyperthermia that we would emphasize are as follows:
There may not be any temperature rise in a specific person in whom