Controlled Trial of Repeated Halothane Anaesthetics in Patients With Carcinoma of the Uterine Cervix Treated With Radium

Trowell, Joan; Pető, Richárd; Smith, Alison C.

doi:10.1097/00132586-197604000-00030

Cited by 10 publications

(13 citation statements)

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“…It has been shown, using serial transaminase estimations, that minor hepatic cell damage in the absence of jaundice may occur with repeated halothane administration (Trowell et al, 1975;Wright et al, 1975). It may be that repeated minor hepatic cellular damage may set off a severe immunological reaction in certain individuals resulting in halothane hepatitis.…”

Section: Discussionmentioning

confidence: 99%

Halothane macrophage migration inhibtiion factor test in halothane-associated hepatitis.

Price¹,

Gibbs²,

Williams³

1977

J Clin Pathol

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SUMMARY As an index of delayed hypersensitivity in vitro halothane macrophage migration inhibition factor tests (halothane-MIF tests) were performed on peripheral blood lymphocytes from five patients with halothane hepatitis. Twenty-two subjects exposed to halothane, but with no evidence ofjaundice, five 'healthy' hospital anaesthetists, nine jaundiced subjects without halothane exposure, and 10 healthy subjects with no history of exposure to halothane were also tested.The halothane-MIF test was positive in four of the five patients with halothane-induced hepatitis; the negative result was in a patient on steroid treatment. The test was negative in all other subjects. Our findings suggest that the halothane-MIF test may be of value in the diagnosis of halothaneinduced hepatitis and as a screening procedure for the identification of susceptible subjects.

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Section: Discussionmentioning

confidence: 99%

Halothane macrophage migration inhibtiion factor test in halothane-associated hepatitis.

Price¹,

Gibbs²,

Williams³

1977

J Clin Pathol

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“…The majority of cases of halothane induced injury (more than 80%) occur in patients after more than one exposure. For instance in one study 4 out of 18 patients (22%) had biochemical evidence of liver damage, subsequently confirmed by biopsy in 2 patients, following repeated halothane anaesthesia (Trowell et al, 1975). This may be as high as 63% after 4 or more exposures (Inman & Mushin, 1974).…”

Section: Halothanementioning

confidence: 97%

“…This most widely used anaesthetic is now accepted as causing hepatic injury (Trowell et al, 1975). The majority of cases of halothane induced injury (more than 80%) occur in patients after more than one exposure.…”

Section: Halothanementioning

confidence: 99%

Drug hepatotoxicity.

Timbrell¹

1983

Brit J Clinical Pharma

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“…The Oxford study (Trowell et al 1975) looked at the effect of halo-Drug Safety 5 (1) 1990 thane and non-halothane anaesthetics on liver function tests in 39 women undergoing treatment for carcinoma of the uterine cervix. The Oxford study (Trowell et al 1975) looked at the effect of halo-Drug Safety 5 (1) 1990 thane and non-halothane anaesthetics on liver function tests in 39 women undergoing treatment for carcinoma of the uterine cervix.…”

Section: Type I Hepatotoxicity -Mild Liver Damagementioning

confidence: 99%

Halothane and Hepatitis

Neuberger

1990

Drug Safety

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Despite early controversy, it is now recognised that halothane anaesthesia may be followed by abnormalities of liver function. The resulting hepatitis may take 1 of 2 forms: in type I, there is a minor degree of disturbance of liver function shown by increased serum transaminases or glutathione-S-transferase in up to 25 to 30% of patients; subsequent re-exposure to halothane is not necessarily associated with evidence of liver damage. In contrast, type II hepatitis is often associated with massive liver cell necrosis, frequently leading to fulminant hepatic failure. This type of liver damage has clinical, serological and immunological features compatible with an immune-mediated idiosyncratic reaction. The incidence is low (between 1 in 3500 and 1 in 35,000 anaesthetic procedures), but the mechanism of halothane hepatitis remains uncertain: there have been extensive animal models showing that halothane has a direct hepatotoxic potential, although the relevance of this to the human patient is not yet clear. Prevention of halothane hepatitis may be difficult, and the only clear way of reducing the incidence is to avoid re-exposure to halothane in those patients who have had a previous adverse reaction to the drug, demonstrated either by unexplained pyrexia or by jaundice. Halothane should also be avoided in those patients where there is a family history of sensitisation to the drug. In such cases, halothane-free equipment should be used, and exposure to other volatile non-halogenated anaesthetics should be avoided.

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Controlled Trial of Repeated Halothane Anaesthetics in Patients With Carcinoma of the Uterine Cervix Treated With Radium

Cited by 10 publications

References 0 publications

Halothane macrophage migration inhibtiion factor test in halothane-associated hepatitis.

Halothane macrophage migration inhibtiion factor test in halothane-associated hepatitis.

Drug hepatotoxicity.

Halothane and Hepatitis

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