"Hepatitis" following halothane-anesthesia
Kreienbühl, G.
Der Anaesthesist 30(1): 1-10
1981
ISSN/ISBN: 0003-2417 PMID: 7008644 Document Number: 174350
"Hepatitis" following halothane-anesthesia is a rare complication, occurring once after about 2500 halothane-anaesthesias. The mortality is estimated to be 20-25%. The disease can be diagnosed by exclusion of other causes only. The differential diagnosis of postoperative jaundice is therefore briefly reviewed. Three hypotheses of possible pathogenic mechanisms are discussed, namely the theory of toxic products of the metabolism of halothane, the theory of delayed hypersensitivity to a metabolite and the theory of coincidence with preexisting unknown liver disease. None of these theories has been proved definitely. The use of halothane is contraindicated if a patient suffered from unexplained pyrexia and jaundice after a previous exposure to halothane. Gamma radiation decomposes halothane to hexachlorofluorobutene, a know hepatotoxin. The repeated use of halothane during irradiation therapy is therefore contraindicated. The risk of "hepatitis" after halothane anaesthesia increases if the patient is exposed to halothane twice within four weeks, especially if he is obese and older than 40 years. The risks and advantages of repeated halothane exposures have to be weighed against the risks of alternative techniques. The increased mortality after repeated anaesthesias within short periods of time, irrespective of the technique used, has to be considered.