Anaesthetics for the Chemically Sensitive
Website Special, March 2003

Question: I am looking for information on relatively safe general anesthetics for people with multiple chemical sensitivities. I  am scheduled for surgery in two weeks and the prospect of anesthetics is a bit scary, since I have chemical sensitivities. Where can I find information
about this issue?

Dr. Gerald Ross responds: MCS or chemically intolerant patients usually do better with anesthetics than they expect to. They are better treated with IVs in glass bottles if available, as the plastic bottles leach the plastic components into the IV liquid solution. Straight saline is preferred over other IV solutions.

However, long experience indicates that the following anesthetic agents are
USUALLY BETTER TOLERATED:

pentothal
long-acting morphine like compounds,
fentenyl,
curare,
scopalamine and similar compounds
Generally MCS or chemically intolerant patients should AVOID the halogenated inhaled anesthetics, as these patients do not recover from them easily or detoxify them well. Patients may have a longer recovery, with prolonged sedation and as a result, longer hospital stays:

AVOID:

Fluothane
Ethrane
Pentrane
If possible, avoid Nitrous Oxide, but many patients will do okay with it, if essential.

Hyperventilation maintained by the anesthesiologist to produce a slight alkalinity in the
patient may also help, or the anesthetist may be willing to add a little bit of sodium bicarbonate to the IV.

The forgoing is taken partly from my experience and also from what Dr. Rea has taught and published in his medical textbook series:  Chemical Sensitivity, W.J.Rea, Vol 4, CRC Press, Lewis Publishers, Boca Raton, 1997, p.2820. 

March 6, 2003

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Re dental anesthetics for people with chemical sensitivities, Dr. Patricia Beresford recommends anesthetics without epinephrine, particularly Citanest Plain which is one to which most people have not had much exposure. It has been well tolerated by many people with chemical sensitivities.

Dr. Gerald Ross and Dr. Patricia Beresford are medical doctors with many years experience treating patients with chemical sensitivities.   Because there is much variation among people with chemical sensitivities, it is impossible to know whether a particular individual will have problems with a particular anesthetic.