As with other agents of this type, halothane anaesthesia has been shown to trigger a skeletal muscle hypermetabolic state leading to high oxygen demand and the clinical syndrome known as malignant hyperthermia (MH). The syndrome includes non specific features such as hypercapnia, muscle rigidity, tachycardia, tachypnoea, cyanosis, arrhythmias and unstable blood pressure. An increase in overall metabolism may be reflected in an elevated temperature. Treatment includes discontinuation of triggering agents, administration of intravenous dantrolene sodium and application of supportive therapy. Cardiac arrhythmias, in particular ventricular arrthymias, have been reported as being very common during FLUOTHANE use. Typically these are without clinical consequences. Bradycardia and/or hypotension may occur during FLUOTHANE anaesthesia. Hypotension may occur particularly during induction. Shivering may be observed during recovery from anaesthesia, especially if the patient is in cool surroundings. Post-operative nausea and vomiting may occur after FLUOTHANE anaesthesia. Anaesthesia with halothane may be followed by abnormalities of liver function or more rarely liver damage (see Contraindications).DRUG INTERACTIONSFLUOTHANE augments the action of non-depolarising muscle relaxants and the muscle relaxant effects of aminoglycosides. FLUOTHANE may augment the hypotension caused by the ganglionic-blocking effect of tubocurarine. Caution should be exercised during the administration of adrenaline to patients anaesthetised with FLUOTHANE as arrhythmias may be precipitated. For this reason the dose of adrenaline should be restricted and an antiarrhythmic agent administered as appropriate. Caution should also be applied for other sympathomimetics, and for aminophylline and theophylline and tricyclic antidepressants, which may also precipitate arrhythmias.
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