A Search for Halothane Liver Complications

Abstract

ALOTHANE (Fluothanes) has beenH a suspect agent as a result of severa1 recent alluding to it as a hepatotoxic chemical. While none of the cases reported showed a conclusive relationship between halothtane and the observed liver pathology, doubts were nevertheless raised. It therefore became incumbent upon each department of anesthesia to search its records for possible cases of liver pathology secondary to halothane anesthesia. The inference projected in the recent literature was that a lack of awareness may have allowed similar cases to go unrecognized as to true etiology.A thorough review was made in our hospital covering the period May 1960 through June 1963. In our 908-bed general hospital, we average approximately 15,000 a n e s t h e t i c procedures a year, which include an average of 3000 obstetric anesthetics in which halothane has not been used. Halothane was introduced in our hospital in May of 1960, and in 1962 we were t h e fourteenth largest user of this agent in the United state^.^ A survey of the surgical division was conducted to see if there were any cases of liver complication reported during the hospital postoperative period. All cases of hepatitis admitted on t h e medical service during the period of study were also analyzed t o determine if any of the cases had received halothane, been discharged from the surgical service, and were then readmitted for hepatitis on the medical service. All autopsies during this period which demonstrated any major liver pathology were analyzed. RESULTSDuring the period of study, 13,024 halothane and 7160 cyclopropane anesthetics were administered, accounting for 56 per cent of all surgical anesthetics (halothane 36 per cent, cyclopropane 20 per cent). The remainder of the cases were done under either sodlium thiopental-nitrous oxide-diethyl ether, or some form of regional anesthesia. All halothane anesthetics are administered utilizing a high flow (4 liters nitrous oxide and 4 liters oxygen) semiclhosed technic.Fifteen anesthetic machines are used in our department to administer halothane

A Prospective Study of Changes in Liver Function After Operation Under Two Forms of General Anaesthesia

“…However, the reports of jaundice in patients who had been anaesthetized with halothane pointed to the need for further studies. Although several retrospective surveys (Keeri-Szantd and Lafleur, 1963;Allen and Metcalfe, 1964;Slater et al, 1964) had shown no relationship between the incidence of liver damage and the administration of halothane, careful studies seemed still to be required, if the relevance of other factors in the production of postoperative liver damage were to be evaluated. Such studies needed to be carried out in man, since the lack of evidence of liver damage in experimental animals given halothane suggested the possibility that their response to this drug might differ from that of man.…”

Liver Injury in the Surgical Patient: A Critical Review

“…The degree of postoperative liver dysfunction appears to be uninfluenced by the type of anaesthesia used (Little and Given, 1964;Joseph, 1964). Retrospective studies of the incidence of postoperative liver failure have shown it to be relatively unaltered irrespective of the changes which have occurred in anaesthetic methods (Dawson et al, 1963;Mazzia, 1963;Keeri-Szant6 and Lafleur, 1963;Wilson, Tarrow and Garvin, 1964;Allen and Metcalf, 1964;Slater et al, 1964;Mushin et al, 1964;Reichmann and Wohlgemuth, 1964;Collins and Fabian, 1964;Henderson and Gordon, 1964).…”

Συμβολη Εις Την Διερευνησιν Της Επιδρασεως Ενος Νεου Πτητικου Αναισθητικου Του Ενφλουρανιου Η Αιθρανιου Επι Της Ηπατικης Λειτουργιας

“…Cl F F Πρόκειται δηλαδή περί ενός άλογονωμένου αιθέρος" 4 . Τό αίθράνιον είναι ϋγρόν δχρουν, πτητικόν, ευχάριστου αιθέριας οσμής.…”