ANESTHESIA Anesthesia-the condition of having sensation (including the feeling of pain) blocked or temporarily taken away.

It is a pharmacologically induced and reversible state of amnesia, analgesia, loss of responsiveness, loss of skeletal muscle reflexes or decreased stress response, or all simultaneously. This allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience. An alternative definition is a "reversible lack of awareness," including a total lack of awareness (e.g. a general anesthetic) or a lack of awareness of a part of the body such as a spinal anesthetic. The word anesthesia was coined by Oliver Wendell Holmes, Sr. in 1846 TYPES OF ANESTHESIA 1.)GENERAL ANESTHESIA is a state of unconsciousness and loss of protective reflexes resulting from the administration of one or more general anaesthetic agents. A variety of medications may be administered, with the overall aim of ensuring hypnosis, amnesia, analgesia, relaxation of skeletal muscles, and loss of control of reflexes of the autonomic nervous system. This medicine is used to keep you completely asleep during surgery. General anesthesia can be used for most procedures surgeries. The medicine may be given as a liquid in your IV. It may also be given as a gas through a face mask, endotracheal tube, or a laryngeal mask airway. An endotracheal tube or "ET" tube is put into your mouth or nose and down your throat into your lungs. The ET tube helps protect your windpipe during surgery. The laryngeal mask airway is also known as LMA. This is a tube with a small mask on the end that fits into the back of your throat instead of down your windpipe. The small mask is filled with air. The ET tube and the LMA allow you to breathe in oxygen or anesthesia gas during surgery. Purposes: Analgesia loss of response to pain, Amnesia loss of memory, Immobility loss of motor reflexes, Hypnosis loss of consciousness, Skeletal muscle relaxation.

2.)LOCAL ANESTHESIA This is medicine given before a procedure or surgery to dull the pain. It is usually given as a shot in several places in and around the surgery area. The shot helps to numb the nerves in that area. This medicine can sometimes be given as an ointment or spray. Tell your caregiver if you are allergic to any numbing medicine, such as "novocaine" or "lidocaine." You are awake during the surgery or procedure. Local anesthesia is best used for tests, procedures, or surgeries where a lot of pain is not expected. 3.)INTRAVENOUS (IV) REGIONAL ANESTHESIA This is anesthesia affecting only a large part of the body, such as a limb or the lower half of the body. Regional anaesthetic techniques can be divided into central and peripheral techniques. The central techniques include so called neuraxial blocks (epidural anaesthesia, spinal anaesthesia). The peripheral techniques can be further divided into plexus blocks such as brachial plexus blocks, and single nerve blocks. Regional anaesthesia may be performed as a single shot or with a continuous catheter through which medication is given over a prolonged period of time, e.g. continuous

peripheral nerve block. Regional anaesthesia can be provided by injecting local anaesthetics directly into the veins of an arm (provided the venous flow is impeded by a tourniquet.) This is called intravenous regional techniques (Bier block). Upon administering, this is medicine is put into an IV in the injured arm or leg. A pressure cuff is put on your upper arm or leg. The pressure cuff is tightened after caregivers tightly wrap your arm or leg with a stretchy bandage. This cuff keeps the medicine in the arm or leg so you do not have pain. You are awake (but may be sleepy) during surgery. You may also be given medicine in your IV so that you are sleepy.
SUBTYPES OF REGIONAL ANESTHESIA:

a.)Epidural analgesia- a form of regional analgesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord. Upon administration, this is medicine numb you from about the nipple line to the waist and down. While lying on your side or sitting up, a catheter (tiny tube) is put into your back through a needle. The needle is then taken out but the catheter is left in place to give you more medicine if needed. You are awake during surgery but may be given medicine in your IV so that you are sleepy. Your lower body is numb and you may be able to move your legs but should not feel pain. Feeling returns to your legs when caregivers stop putting medicine in the catheter and when the medicine wears off. Epidural anesthesia is good for procedures below the waist. Epidural anesthesia can give longer lasting pain relief than spinal anesthesia. Indications of epidural anesthesia: Injecting medication into the epidural space is primarily performed for analgesia. This may be performed using a number of different techniques and for a variety of reasons. Additionally, some of the side-effects of epidural analgesia may be beneficial in some circumstances (e.g., vasodilation may be beneficial if the patient has peripheral vascular disease). When a catheter is placed into the epidural space (see below) a continuous infusion can be maintained for several days, if needed. Epidural analgesia may be used:

For analgesia alone, where surgery is not contemplated. An epidural for pain relief (e.g. in childbirth) is unlikely to cause loss of muscle power, but is not usually sufficient for surgery. As an adjunct to general anaesthesia. The anaesthetist may use epidural analgesia in addition to general anaesthesia. This may reduce the patient's requirement for opioid analgesics. This is suitable for a wide variety of surgery, for example gynaecological surgery (e.g. hysterectomy), orthopaedic surgery (e.g. hip replacement), general surgery (e.g. laparotomy) and vascular surgery (e.g. open aortic aneurysm repair). See also caudal epidural, below.

As a sole technique for surgical anaesthesia. Some operations, most frequently Caesarean section, may be performed using an epidural anaesthetic as the sole technique. Typically the patient would remain awake during the operation. The dose required for anaesthesia is much higher than that required for analgesia.

For post-operative analgesia, after an operation where the epidural was used as either the sole anesthetic, or was used in combination with general anesthesia. Analgesics are given into the epidural space for a few days after surgery, provided a catheter has been inserted. Through the use of a patient-controlled epidural analgesia (PCEA) infusion pump, a patient has the ability to give an occasional extra dose of post-surgical pain medications administered through the epidural.

For the treatment of back pain. Injection of analgesics and steroids into the epidural space may improve some forms of back pain. See below.

For the treatment of chronic pain or palliation of symptoms in terminal care, usually in the short- or medium-term.

The epidural space is more difficult and risky to access as one ascends the spine, so epidural techniques are most suitable for analgesia for the chest, abdomen, pelvis or legs. They are (usually) much less suitable for analgesia for the neck, or arms and are not possible for the head (since sensory innervation for the head arises directly from the brain via cranial nerves rather than from the spinal cord via the epidural space.) Relative contraindications Anatomical abnormalities, such as spina bifida or scoliosis Previous spinal surgery (where scar tissue may hamper the spread of medication, or may cause an acquired tethered spinal cord) Certain problems of the central nervous system, including multiple sclerosis or syringomyelia Certain heart-valve problems (such as aortic stenosis, where the vasodilation induced by the anesthetic may impair blood supply to the thickened heart muscle.) Absolute contraindications Bleeding disorder (coagulopathy) or anticoagulant medication (e.g. warfarin) - risk of spinal cord-compressing hematoma Infection near the point of intended insertion Infection in the bloodstream which may "seed" via the catheter into the (otherwise relatively impervious) central nervous system Uncorrected hypovolemia (low circulating blood volume) Allergy to the anesthetic b.)SPINAL ANAESTHESIA- also called spinal analgesia or sub-arachnoid block (SAB)-is a form of regional anaesthesia involving injection of a local anaesthetic into the subarachnoid space/cerebrospinal fluid generally through a fine needle, usually 9 cm long (3.5 inches). For extremely obese patients, some anaesthesiologists prefer spinal needles which are 12.7 cm long (5 inches). The tip of the spinal needle has a point or small bevel. Upon administration this is medicine put into your back through a shot while lying on your side or sitting up. You are awake during surgery but may be given medicine in your IV so that you are sleepy. You are numb from about the nipple line to the waist and down. How high the numbness goes depends on where your surgery will be. You are not able to move your legs when the medicine starts to work. You can move your legs in 1 to 4 hours when the medicine wears off. Spinal anesthesia is best for surgeries below the waist. Indication:This technique is very useful in patients having an irritable airway (bronchial asthma or allergic bronchitis), anatomical abnormalities which make endotracheal intubation very difficult (micrognathia), borderline hypertensives where administration of general anaesthesia or endotracheal intubation can further elevate the blood pressure, procedures in geriatric patients. injected substances: Bupivacaine (Marcaine) is the local anaesthetic most commonly used, although lignocaine (lidocaine), tetracaine, procaine, ropivacaine, levobupivicaine and cinchocaine may also be used. Sometimes a vasoconstrictor such as epinephrine is added to the local anaesthetic to prolong its duration. Of late, many anaesthesiologists are preferring to add opioids like morphine, fentanyl, orbuprenorphine, or non-opioids like clonidine, to the local anaesthetic used in a spinal injection, to give a smoother effect and to provide prolonged pain relief once the action of the spinal local anaesthetic has worn off. Baricity refers to the density of a substance compared to the density of human cerebral spinal fluid. Baricity is used in anaesthesia to determine the manner in which a particular drug will spread in the intrathecal space. Usually, the hyperbaric, (for example, hyperbaric bupivacaine) is chosen, as its spread can be effectively and predictably controlled

by the anaesthesiologist, by tilting the patient. Hyperbaric solutions are made more dense by adding dextrose to the mixture. c.)PERIPHERAL NERVE BLOCKS A nerve block is a shot of anesthetic near a specific nerve or group of nerves. It blocks pain in the part of the body supplied by the nerve. Nerve blocks are most often used for procedures on the hands, arms, feet, legs, or face. This type of anesthesia is medicine put into your arm or leg through a shot. Your arm or leg will be numb for 4 to 18 hours depending on the type of medicine used. You are awake (but may be sleepy) during surgery. You may also be given medicine in your IV so that you are sleepy. This type of block is also called an axillary block if the anesthesia is given in your armpit. This anesthesia can be used for many types of surgery on the arms or legs. Difference between epidural and spinal anesthesia The involved space is larger for an epidural, and subsequently the injected dose is larger, being about 10-20 ml in epidural anesthesia compared to 1,5-3,5 ml in a spinal. In an epidural, an indwelling catheter may be placed that avails for additional injections later, while a spinal is usually one-shot only; though a continuous spinal can also be administered, especially in pain management (with morphine pumps). The onset of analgesia is approximately 1530 minutes in an epidural, while it is approximately 5 minutes in a spinal. An epidural usually doesn't cause significant neuromuscular block at the lower effective analgesic dosages, while a spinal more often does. An epidural may be given at a thoracic or lumbar site, while a spinal must be injected below L2 to avoid piercing the spinal cord. With epidural, it is possible to create segmental blocks as opposed to spinal where the block involves all segments below the highest level of anesthesia. The extension of the block with epidural anesthesia is highly dependent on the volume and rate of injection. The position of the patient has little to no impact on the level of the block. With spinal anesthesia, the density of the solution combined with the position of the patient influences the level of the block significantly.

Consequently, epidural is safer if a higher level of block is required. 4.) DISSOCIATIVE ANESTHESIA A class of psychoactive drugs which are said to reduce or block signals to the conscious mind from other parts of the brain.[1] Although many kinds of drugs are capable of such action, dissociatives are unique in that they do so in such a way that they produce hallucinogenic effects, which may include sensory deprivation, dissociation, hallucinations, and dream-like states or trances.[2] Some, which are nonselective in action and affect the dopamine and/or opioid systems, may be capable of inducing euphoria. Many dissociatives have general depressant effects and can produce sedation, respiratory depression analgesia, anesthesia, and ataxia, as well as cognitive and memory impairment and amnesia. OTHER TYPES OF ANESTHESIA: 1.)Interscalene Block: This medicine is given as a shot in your neck to numb your shoulder and arm. You are awake during surgery but may be given medicine in your IV so that you are sleepy. This kind of anesthesia may be given in addition to medicine to keep you completely asleep during surgery. You may still feel pressure or pushing during surgery but should not feel pain. Feeling returns when the medicine wears off.

2.)Saddle Block or Caudal (kaw-dull) Anesthesia: This is medicine used to numb you below the waist. You may lie on your abdomen (belly) while your caregiver puts a shot of medicine in the lowest part of your spine. You may lie on your back with your legs up in leg holders (stirrups). You are awake during the surgery but may be given medicine in your IV so that your are sleepy. Saddle block or caudal anesthesia is used for procedures or surgeries of the rear end or legs. NEGATIVE EFFECTS OF ANESTHESIA There are risks with anesthesia and your caregivers will watch you closely to treat any problems. Some surgeries cannot be done at all if you choose not to have anesthesia. Call your caregiver if you are worried or have questions about your care. You could have a bad reaction to the medicine. You could feel sick to your stomach after surgery. It may take awhile for the medicine to wear off. You may have a sore throat after general anesthesia. Ask your caregiver about using throat lozenges or gargle with warm salt water. The sore throat is usually gone in 1 to 2 days. You could have a seizure or heart attack. Your temperature could go very high and you might die. You could have long-lasting numbness, dolor, or loss of function of body parts after block types of anesthesia. Do not make important decisions for 24 hours after having anesthesia because anesthesia medicine may make your thinking unclear.

ANESTHESIA MEDICATIONS ANECTINE Generic Name: Succinylcholine Brand Name: Examples include Anectine and Quelicin Anectine has been associated with rapid muscle breakdown resulting in life-threatening heart rhythms, cardiac arrest, and death in children. These children appeared to be healthy, but were later found to have certain undiagnosed muscle problems (eg, Duchenne muscular dystrophy). Male children and children younger than 8 years old seem to be at a higher risk. Cases have also been reported in adolescents. Because it is hard to determine which children may be at risk, Anectine should only be used in an emergency situation. USES: Relaxing muscles during surgery or when using a breathing machine (ventilator). It is also used to induce anesthesia or when a tube must be inserted in the windpipe. It may also be used for other conditions as determined by your doctor. Anectine is a depolarizing muscle relaxant. It works by keeping muscles from contracting, which causes paralysis of the muscles in the face and those used to breathe and move. CONTRAINDICATION

you are allergic to any ingredient in Anectine you have recently had a severe burn, trauma, nerve damage, or an upper body movement injury you have a personal or family history of muscle disease or malignant hyperthermia (a life-threatening state that includes high body temperatures) MEDICINES THAT MAY INTERACT with:

Digoxin because the risk of abnormal heart rhythms may be increased Aminoglycosides (eg, gentamicin), aprotinin, beta-adrenergic blockers (eg, propranolol), chloroquine, clindamycin, cyclophosphamide, glucocorticoids (eg, prednisone), lidocaine, lithium, magnesium salts, metoclopramide, oral contraceptives (eg, birth control pills), oxytocin, procainamide, promazine, quinidine, quinine, terbutaline, or trimethaphan because they may increase the risk of Anectine's side effects

DIPRIVAN Generic Name: Propofol Brand Name:Diprivan Diprivan is used to start or maintain anesthesia during certain surgeries, tests, or procedures. It may also be used for other conditions as determined by your doctor. Diprivan is a general anesthetic. It is unknown exactly how this medication works. CONTRAINDICATION: you are allergic to any ingredient in this medication you are allergic to eggs, egg products, soybeans, or soy products MEDICINES THAT MAY INTERACT with : Benzodiazepines (eg, alprazolam), narcotic pain relievers (eg, morphine), or other sedatives (eg, chloral hydrate) because they may increase the risk of this medication 's side effects.

LIDOCAINE VISCOUS Generic Name: lidocaine viscous Brand Names: Xylocaine Viscous

Lidocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body. Lidocaine viscous is used to treat sores inside the mouth, during dental procedures to numb the gums, and to numb the skin for a medical procedure (such as getting stitches). Lidocaine viscous may also be used for other purposes not listed in this medication guide.

NUBAIN Generic Name: Nalbuphine Brand Name: Nubain USES:Treating and preventing moderate to severe pain. It can also be used for pain relief before and after surgery and during childbirth. It may also be used for other conditions as determined by your doctor.Nubain is an analgesic. It works by blocking certain receptor sites in the central nervous system, which helps to decrease pain. CONTRAINDICATION:

you are allergic to any ingredient in Nubain or to another opioid analgesic (eg, morphine or hydromorphone) you have diarrhea due to poisoning, a certain type of bowel problem (pseudomembranous colitis), or are dependent on any medicine or substance you are taking sodium oxybate (GHB) MEDICINES MAY INTERACT with:

Naltrexone because it could decrease the effectiveness of Nubain Alcohol, barbiturate anesthetics (eg, thiopental), cimetidine, narcotic analgesics (eg, fentanyl), phenothiazines (eg, promethazine), or sodium oxybate (GHB) because side effects, such as increased risk of slow or difficult breathing or drowsiness leading to unresponsiveness or coma, may occur Methadone because its effectiveness may be decreased by Nubain

XYLOCAINE JELLY GEL Generic Name: Lidocaine Brand Name: Generic only. No brands available USES: Decreasing pain and discomfort resulting from urinary tract procedures or the placement of endotracheal (airway) tubes. It may also be used for other conditions as determined by your doctor. Xylocaine Jelly Gel is an anesthetic. It works by preventing nerves from transmitting painful impulses to the brain. CONTRAINDICATION: you are allergic to any ingredient in Xylocaine Jelly Gel or to other similar medicines (eg, amide-type anesthetics. SEVERE side effects occur: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); choking; confusion; dizziness or lightheadedness; fast breathing; fast, slow, or irregular heartbeat; fever; mood or mental changes; ringing in the ears or hearing changes; seizures; shortness of breath; swelling of the throat; vision changes.

Important safety information:

Xylocaine Jelly Gel may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Xylocaine Jelly Gel with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Tell your doctor or dentist that you take Xylocaine Jelly Gel before you receive any medical or dental care, emergency care, or surgery. Xylocaine Jelly Gel may make it difficult for you to swallow. Do not eat anything for at least 1 hour after Xylocaine Jelly Gel has been applied in the mouth or throat area. Numbness of the tongue may cause you to bite the inside of your mouth accidentally. Do not eat any food or chew gum while your mouth or throat area is numb. PREGNANCY and BREAST-FEEDING: It is not known if Xylocaine Jelly Gel can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Xylocaine Jelly Gel while you are pregnant. It is not known if Xylocaine Jelly Gel is found in breast milk after topical use. If you are or will be breast-feeding while you use Xylocaine Jelly Gel, check with your doctor. Discuss any possible risks to your baby. XYLOCAINE VISCOUS SOLUTION Generic Name: Lidocaine Brand Name: Generic only. No brands available. USES: Temporarily relieving pain of the mouth and throat. It is also used to reduce gagging during certain dental procedures or for other conditions as determined by your doctor. Xylocaine Viscous Solution is a local anesthetic. It works by preventing nerves from transmitting painful impulses to the brain. Some medical conditions may interact with Xylocaine Viscous Solution. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a blood infection or severe injury of the mouth or throat if you have heart, liver, or kidney problems if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to any anesthetic medicine MEDICINES MAY INTERACT with Xylocaine Viscous Solution Amiodarone, beta-adrenergic blockers (eg, metoprolol), cimetidine, or mexiletine because side effects, such as confusion, dizziness, lightheadedness, or tiredness, may occur. This may not be a complete list of all interactions that may occur. Ask your health care provider if Xylocaine Viscous Solution may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

ROBINUL Generic Name: Glycopyrrolate Brand Name: Robinul USES:Reducing secretions in the mouth, throat, airway, and stomach before surgery. It is used before and during surgery to block certain reflexes and to protect against certain side effects of some medicines. It is used along with other medicines to treat stomach ulcers. It may also be used for other conditions as determined by your doctor.Robinul is an anticholinergic. It blocks the activity of a certain chemical (acetylcholine) in the body, which decreases secretions and decreases side effects caused by medicines that may increase the action of acetylcholine in the body. CONTRAINDICATION:

you are allergic to any ingredient in Robinul if you have heart problems caused by bleeding you are being treated for an ulcer and you also have glaucoma, trouble urinating (eg, bladder neck obstruction), certain stomach or bowel problems (eg, stomach or bowel blockage, bowel muscle problems, severe ulcerative colitis, toxic megacolon), certain esophagus problems (eg, achalasia, reflux), or myasthenia gravis MEDICINES MAY INTERACT with: Anticholinergics (eg, benztropine), phenothiazines (eg, chlorpromazine), potassium chloride, or tricyclic antidepressants (eg, amitriptyline) because Robinul's side effects may be increased by Robinul ANESTHESIA - RISKS AND COMPLICATIONS Although all types of anesthesia involve some risk, major side effects and complications from anesthesia are uncommon. Your specific risks depend on your health, the type of anesthesia used, and your response to anesthesia. PERSONAL RISK FACTORS Your age may be a risk factor. In general, the risks associated with anesthesia and surgery increase in older people. Certain medical conditions, such as heart, circulation, or nervous system problems, increase your risk of complications from anesthesia. Some medicines can raise your risk of problems too. Make a list of all the prescription and over-the-counter medicines you take. And share your list with your doctors.

If you smoke, drink alcohol, or use illegal drugs, you may be more likely to have problems from anesthesia. It's important that you are honest when you talk with your surgeon and anesthesia specialist. COMPLICATIONS FROM LOCAL ANESTHESIA When used properly, local anesthetics are safe and have few major side effects. But in high doses, local anesthetics can have toxic effects caused by being absorbed through the bloodstream into the rest of the body (systemic toxicity). This may significantly affect your breathing, heartbeat, blood pressure, and other body functions. Because of these potential toxic effects, equipment for emergency care must be immediately available when local anesthetics are used. COMPLICATIONS FROM REGIONAL ANESTHESIA For regional anesthesia, an anesthetic is injected close to a nerve, a bundle of nerves, or the spinal cord. In rare cases, nerve damage can cause persistent numbness, weakness, or pain. Regional anesthesia (regional nerve blocks, epidural and spinal anesthesia) also carries the risk of systemic toxicity if the anesthetic is absorbed through the bloodstream into the body. Other complications include heart or lung problems, and infection, swelling, or bruising (hematoma) at the injection site. Spinal anesthesia medicine is injected into the fluid that surrounds the spinal cord (cerebrospinal fluid). The most common complication of spinal anesthesia is a headache caused by leaking of this fluid. It is more common in younger people. A spinal headache may be treated quickly with a blood patch to prevent further complications. A blood patch involves injecting a small amount of the person's own blood into the area where the leak is most likely occurring to seal the hole and to increase pressure in the spinal canal and relieve the pull on the membranes surrounding the canal. COMPLICATIONS FROM GENERAL ANESTHESIA Serious side effects of general anesthesia are uncommon in people who are otherwise healthy. But because general anesthesia affects the whole body, it is more likely to cause side effects than local or regional anesthesia. Fortunately, most side effects of general anesthesia are minor and can be easily managed. General anesthesia suppresses the normal throat reflexes that prevent aspiration, such as swallowing, coughing, or gagging. Aspiration occurs when an object or liquid is inhaled into the respiratory tract (the windpipe or the lungs). To help prevent aspiration, an endotracheal (ET) tube may be inserted during general anesthesia. When an ET tube is in place, the lungs are protected so stomach contents cannot enter the lungs. Aspiration during anesthesia and surgery is very uncommon. To reduce this risk, people are usually instructed not to eat or drink anything for a certain number of hours before anesthesia so that the stomach is empty. Anesthesia specialists use many safety measures to minimize the risk of aspiration. Insertion or removal of airways may cause respiratory problems such as coughing; gagging; or muscle spasms in the voice box, or larynx (laryngospasm), or in the bronchial tubes in the lungs (bronchospasm). Insertion of airways also may cause an increase in blood pressure (hypertension) and heart rate (tachycardia). Other complications may include damage to teeth and lips, swelling in the larynx, sore throat, and hoarseness caused by injury or irritation of the larynx. RISKS FROM REACTIONS TO ANESTHETIC MEDICINES Some anesthetic medicines may cause allergic or other abnormal reactions in some people, but these are rare. If you suspect you may have such a problem, you should tell both your surgeon and anesthesia specialist well before your surgery. Testing will then be arranged as needed. A rare, potentially fatal condition called malignant hyperthermia (MH) may be triggered by some anesthetics. The anesthetics most commonly associated with malignant hyperthermia include the potent inhalation anesthetics and the

muscle relaxant succinylcholine. For more information, see the listing for the Malignant Hyperthermia Association of the United States (MHAUS) in the Other Places to Get Help section of this topic.