- Medical consultation: cardiac function, respiratory status, steroid use (possible need for stress-dose steroids)
- Routine approach: Prefer local anesthesia and nonpharmacologic guidance; avoid respiratory depressants
- Anesthesia setting: For deep sedation or GA, use an experienced anesthesia team and a setting with the necessary cardiac, respiratory, and postoperative support; substantial cardiopulmonary weakness generally favors hospital care
- Positioning and visits: Treat in the wheelchair or support the head and trunk; short visits
- Prevention: Caregiver brushing, power toothbrush, fluoride; plan for declining dexterity
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These drug reactions are distinct from inherited malignant-hyperthermia susceptibility. PPMD, MHAUS-reviewed surgery and anesthesia guidance.