Anesthetic List for MH-Susceptible Patients Anesthetic Agent Choice for the MH-Susceptible Patient

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Anesthetic List for MH-Susceptible Patients Anesthetic Agent Choice for the MH-Susceptible Patient The following anesthetic agents are known triggers of MH and are not safe for use in MH-susceptible patients: Unsafe Anesthetic Agents for MHS Patients What Drugs trigger MH and are Not Safe? Inhaled General Anesthetics Choroform (Trichloromethane, Methyltrichloride) Desflurane Enflurane Halothane Isoflurane Methoxyflurane Sevoflurane Trichloroethylene Xenon (Rarely Used) Depolarizing Muscle Relaxants Trigger MH Succinylcholine (Suxamethonium) All other anesthetic agents outside of these two categories of Volatile anesthetic agents and depolarizing muscle relaxants are considered safe (see below for a sample). Safe Anesthetic Agents for MH Patients Barbiturates / Intravenous Narcotics (Opioids) Anxiety Relieving Medications Anesthetics Alfentanil (Alfenta) Ativan (Lorazepam) Diazepam Anileridine Centrax Etomidate (Amidate) Codeine (Methyl Morphine) Dalmane (Flurazepam) Hexobarbital Diamorphine Halcion (Triazolam) Ketamine (Ketalar) Fentanyl (Sublimaze) Klonopin Methohexital (Brevital) Hydromorphone (Dilaudid) Librax Midazolam Meperidine (Demerol) Librium (Chlordiazepoxide) Pentobarbital Methadone Midazolam (Versed) Propofol (Diprivan) Morphine Paxipam (Halazepam) Thiopental (Pentothal) Naloxone Restoril (Temazepam) Oxycodone Serax (Oxazepam) Inhaled Non-Volatile General Anesthetic Phenoperidine Tranxene (Clorazepate) Nitrous Oxide Remifentanil Valium (Diazepam) Sufentanil (Sufenta Local Anesthetics Amethocaine Safe Muscle Relaxants Articaine Arduan (Pipecuronium) Bupivicaine Curare (The active ingredient is Dibucaine Tubocurraine) Etidocaine Gallamine Eucaine Metocurine Lidocaine (Xylocaine) Mivacron (Mivacurium) Levobupivacaine Neuromax (Doxacurium) Mepivicaine (Carbocaine) Nimbex (Cisatracurium) Procaine (Novocain) Norcuron (Vecuronium) Prilocaine (Citanest) Pavulon (Pancuronium) Ropivacaine Tracrium (Atracurium) Stovaine Zemuron (Rocuronium) .

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Anaesthetic Experience with Paediatric Interventional Cardiology
320 Occasional Survey Anaesthetic experience with paediatric inter- Shobha Malviya MD, Frederick A. Burrows MD FRCPC, Albert E. Johnston MD FRCPC, Lee N. Benson MD FRCPC ventional cardiology Anaesthetic and sedation techniques, complications and out- In recent years interventional cardiologic procedures have comes were reviewed in 176 children undergoing 184 interven- replaced thoracic and cardiac surgery in the treatment of tional cardiologic procedures. Techniques included sedation certain cardiac anomalies in children. Balloon dilatation only, and ketamine, inhalational or narcotic anaesthesia. is particularly effective in treating pulmonary valve Ketamine infusion was the technique most frequently used. stenosis and is also performed as a nonsurgical alternative Ketamine was associated with a higher incidence of respiratory for patients with aortic valve stenosis, recoaretation of the complications (P < 0.05) than the other techniques. The higher aorta and pulmonary artery stenosis. Insertion of an incidence of hypercarbia (15.6 per cent), which did not affect occlusion device is used to treat patent ductus arteriosus. outcome, may be attributable to the use of supplemental Procedures performed in the cardiac catheterisation sedatives. The incidence of upper airway obstruction (7.8 per suite require a darkened room, allow poor access to the cenO was similar to that of previous studies. Vascular compro- often critically ill patient and present the potential for mise resulted from the procedure in 33 patients, necessitating sudden devastating complications, including rupture of a surgical correction in 16. Cardiac perforation occurred in four cardiac chamber. In addition, interventional procedures cases, causing one death. Pulmonary valve stenosis was most require a steady haemodynamic state before oxygen amenable to balloon dilatation and aortic valve stenosis least saturation and pressures in the various cardiac chambers amenable.
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