Methohexital; Histamine Release

[SigmaSRNA]

I know thiopental is a histamine releaser but what about methohexital? I can't find it in Barash and I don't have a Miller to look at.

[jwk]

Some personal thoughts. i have used thiopental and methohexital (Brevital) in thousands of cases. If either of them have a histamine response, it is minimal. I have used it on many, many asthmatics (almost endemic in my part of the country) and have not seen any significant histamine release.

One of the surgeons I work with requests benadryl on his facial plastic cases, because he thinks (it has been published, also) that it prevents a histamine response at the area of surgical discection. His patients do incredibly well and have little or no edema the next day.

I personally have the histamine response to morphine. Instead of pre-treating me with benadryl, just give me another narcotic. I recently had back surgery and dilaudid worked fine.

I am rather a purist--don't pre-treat much, hardly ever reverse anything, just watch the timing of drugs and watch the patients' response. There are a lot of problems with polypharmacy and reversal of most meds. In my opinion, but based on over 46 years of doing this.

Yoga CRNA

Excellent post, excellent points. Benadryl is part of the anti-emetic cocktail that some of our plastic surgeon's are insisting on as well. Zofran, decadron, benadryl on every patient. And I agree 100% -polypharmacy often ends up causing more trouble than it's worth.

[London88]

I trained at a place that frequently used thiopental for induction. We never gave bendryl or anything else to prevent histamine release. The same goes for morphine used it on a frequent basis and never pretreated with anything.

[athomas91]

there is a theory that benedryl can actually make it worse by blocking the "h3 receptors" which actually turn off the histamine response - ... but anyway... i agree w/ yoga - don't use a telephone poll to kill a gnat...why give 8 meds when you can change the problem med.