Certified Nurses Operating Room (CNOR) Practice Exam

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Which inhalational anesthetic should be avoided in patients with Malignant Hyperthermia?

Sevoflurane
Halothane
Isoflurane
Desflurane

The correct answer is: Halothane

Halothane is the inhalational anesthetic that should be avoided in patients with Malignant Hyperthermia (MH). This condition is a genetically inherited disorder that can be triggered by certain anesthetic agents, particularly those in the class of volatile anesthetics. Halothane is known for its association with the development of MH due to its historical use and propensity to induce a hypermetabolic state in susceptible individuals. When halothane is administered, it can prompt a cascade of reactions that leads to a rapid increase in calcium release from the sarcoplasmic reticulum of skeletal muscle, resulting in increased muscle metabolism, increased carbon dioxide production, and a risk of hyperthermia. Therefore, avoiding halothane is critical for the safety of patients with a history or family history of MH. In contrast, the other anesthetics listed, like sevoflurane, isoflurane, and desflurane, have not shown the same level of association with provoking MH, although caution should still be exercised with all volatile anesthetics in these patients. Nonetheless, halothane's specific links to MH make it the primary agent to avoid.