Possible Interaction: Epinephrine and Halothane

“The arrhythmogenic dose of epinephrine CADE) during one MAC of halothane in dogs was increased from 1.13 ± 0.21 to 3.14 ± 0.89 μg·kg−l ± min−1 by the administration of 0.3 mg/kg of DL.”

“Katz and associates,3 on the other hand, considered injection of limited quantities of epinephrine during induction of anesthesia with halothane to be safe provided certain precautions were observed.”

“ Halothane and pancuronium are contraindicated, while large doses of local anaesthetics and epinephrine should be avoided in neuraxial blocks.”

“Sevoflurane (0.13-0.91 mM) and halothane (0.49-1.25 mM) inhibited secondary platelet aggregation induced by adenosine diphosphate (1-10 micro Meter) and epinephrine (1-10 micro Meter) without altering primary aggregation.”

“Cutaneous infiltration of dilute solutions of epinephrine for hemostasis during halothane anesthesia can result in ventricular dysrhythmias, Our clinical experience, published reports, and a study comparing piglets with adult swine suggest that children may be less susceptible than adults to dysrhythmias under these conditions.”

“The presence of PAC and tachycardia emphasize the need for continuous ECG monitoring and caution during halothane anesthesia with epinephrine injection.”

“Aggregation induced by halothane could be potentiated by small doses of adrenaline or ADP and in some individuals by caffeine.”

“There should be no restriction to spontaneous respirations, however I cannot speak from experience as I prefer to avoid the combination of adrenaline and halothane even with controlled ventilation.”

“Increased cardiac sensitivity to epinephrine during halothane anesthesia has been well documented; however, there are few reports of increased cardiac irritability due to interaction between halothane anesthesia and aminophylline.”

“Although, halothane has an excellent safety record and comes close to being the ideal inhalational anesthetic it does have some undesirable effects, including incompatibility with adrenaline and the possibility of causing disturbed hepatic function when given repeatedly.”

“Since the introduction of halothane as an anaesthetic there have been several reports about cardiac arrhythmias during application of epinephrine in combination with halothane.”