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:

• Inhaled General Anesthetics
• Desflurane
• Enflurane
• Ether
• Halothane
• Isoflurane
• Methoxyflurane
• Sevoflurane
• Depolarizing Muscle Relaxants Trigger MH
• Succinylcholine

All other anesthetic agents outside of these two categories of Volatile anesthetic agents and depolarizing muscle relaxants are considered safe.

Safe Anesthetic Agents for MH Patients:

Barbiturates / Intravenous Anesthetics

•  Diazepam
•  Etomidate (Amidate)
•  Hexobarbital
•  Ketamine (Ketalar)
•  Methohexital (Brevital)
•  Midazolam
•  Pentobarbital
•  Propofol (Diprivan)
•  Thiopental (Pentothal)

Inhaled Non-Volatile General Anesthetic

• Nitrous Oxide

Local Anesthetics

• Amethocaine
• Articaine
• Bupivicaine
• Dibucaine
• Etidocaine
• Eucaine
• Lidocaine (Xylocaine)
• Levobupivacaine
  Mepivicaine (Carbocaine)
  Procaine (Novocain)
• Prilocaine (Citanest)
• Ropivacaine
• Stovaine

Narcotics (Opioids)

• Alfentanil (Alfenta)
• Anileridine
• Codeine (Methyl Morphine)
• Diamorphine
• Fentanyl (Sublimaze)
• Hydromorphone (Dilaudid)
• Meperidine (Demerol)
• Methadone
• Morphine
• Naloxone
• Oxycodone
• Phenoperidine
• Remifentanil
• Sufentanil (Sufenta)

Safe Muscle Relaxants

• Arduan (Pipecuronium)
• Curare (The active ingredient is Tubocurraine)
• Gallamine
• Metocurine
• Mivacron (Mivacurium)
• Neuromax (Doxacurium)
• Nimbex (Cisatracurium)
• Norcuron (Vecuronium)
• Pavulon (Pancuronium)
• Tracrium (Atracurium)
• Zemuron (Rocuronium)

Anxiety Relieving Medications

•  Ativan (Lorazepam)
•  Centrax
•  Dalmane (Flurazepam)
•  Halcion (Triazolam)
•  Klonopin
•  Librax
•  Librium (Chlordiazepoxide)
•  Midazolam (Versed)
•  Paxipam (Halazepam)
•  Restoril (Temazepam)
•  Serax (Oxazepam)
•  Tranxene (Clorazepate)
•  Valium (Diazepam)