World Anesthesia Day Spotlight: A Field Redefining Patient Safety
At the heart of Canada’s top anesthesia care teams is a specialty pushing the boundaries of patient safety: malignant hyperthermia (MH) research and care. The University Health Network (UHN) is recognised as a world leader in MH investigation, education, and clinical management. Dr. Sheila Riazi, a clinician-scientist and Director of the Malignant Hyperthermia Investigations Unit (MIHU), explains why anesthesiologists are central to both routine and crisis care in the operating room and beyond.
What does an anesthesiologist do?
Many people underestimate the breadth of an anesthesiologist’s responsibilities. Dr. Riazi clarifies, “We are the physicians responsible for the most critical moments of surgical care—airway management, cardiovascular and respiratory stability, blood loss control, and fluid balance.” The role spans every phase of surgery: preoperative assessment, intraoperative management, and postoperative recovery and pain control. Anesthesiologists are trained to act decisively in seconds, and they are at the forefront of innovations in patient safety and perioperative optimization.
Beyond the Operating Room
In addition to guiding anesthesia during procedures, UHN anesthesiologists influence a broad spectrum of care. They enable hyperbaric oxygen therapy for severe burns and radiation poisoning, assist patients with chronic pain conditions such as Ehlers–Danlos syndrome, and lead research that advances diagnosis and treatment. They also educate the next generation of clinicians, residents, and fellows, ensuring knowledge and expertise continue to grow across the system.
Malignant Hyperthermia: A Life-Saving Focus
Malignant hyperthermia represents the intersection of anesthesia, genetics, and crisis management. It is a rare, life-threatening reaction triggered by certain anesthetic drugs in genetically predisposed individuals. Though MH is uncommon—about 3 in 1,000 people carry the disease gene—the consequences can be dire, with crises evolving rapidly during or after surgery. Mortality has decreased dramatically with improved recognition and treatment, yet it remains a critical challenge with current estimates between 10% and 20% in some settings.
UHN’s MIHU: Canada’s Full-Spectrum MH Resource
Founded in the 1970s by Dr. Beverly Britt, MIHU established the gold standard in MH diagnostic testing. Today, UHN houses Canada’s only full-spectrum MH diagnostic and research program, making it a lifeline for patients across North America. The unit conducts groundbreaking work to identify genetic and molecular biomarkers, refine diagnostic accuracy, and enable personalized risk assessment. It also pioneers training for teams in MH response and investigates potential treatments for muscle-related symptoms in MH survivors.
Leading with Data, Collaboration, and Care
Dr. Riazi’s leadership places MIHU at the forefront of MH science. Ongoing studies aim to improve diagnostics, understand genetic and molecular underpinnings, and optimize crisis response. Cross-institution collaborations, including ties with Mount Sinai and Women’s College Hospital, amplify UHN’s impact and knowledge dissemination. Each discovery brings clinicians closer to faster identification, quicker intervention, and better outcomes for patients facing MH risk.
What This Means for Patients and Families
Awareness and preparedness are the first lines of defense. Simple steps—sharing family histories of anesthesia complications, noting unexplained deaths during surgery, or episodes of exercise- or heat-induced muscle breakdown—can dramatically alter risk assessments. Genetic testing and counseling are increasingly accessible, enabling proactive planning before procedures. Dr. Riazi emphasizes, “With awareness, preparedness and rapid treatment, malignant hyperthermia is entirely manageable.”
A Call to Action: The Collective Effort of Anesthesiology
UHN’s leadership spans research, education, and clinical care, underscoring how anesthesiologists are transforming patient safety. The MIHU’s work—diagnostic excellence, biomarker discovery, and clinical readiness—offers meaningful, tangible benefits to people at risk of MH crises. As Dr. Riazi notes, this is not just about saving lives in the operating room; it’s about building systems prepared for rare but catastrophic events.
Looking Ahead
As research advances, the MH community anticipates better diagnostic tools, personalized risk profiles, and innovative therapies. UHN’s continued dedication to training, collaboration, and patient-centered care ensures that malignant hyperthermia care remains a dynamic field where seconds count and outcomes can be transformed.
