What is the most sensitive early sign of malignant hyperthermia during general anesthesia?

Increased end- expiratory c)2 tension (peco2) -anesthesia-general-malignant hyperthermia is a clinical syndrome that may develop rapidly or take hours to manifest, sometimes not occuring until the patient is in the recovery room. clinical signs include hypertension, tachycardia, respiratory acidosis, metabolic acidosis, muscle rigidity, myoglobinuria, and fever. the diagnosis of malignant hyperthermia is unlikely, however, if only one of these signs is manifested. because malignant hypethermia is a metabolic disorder, one of the first signs is an increase in the production of co2 and concomitant respiratory acidosis. this is the most reliable early sign of this syndrome