Key result
The incidence of halothane hepatitis in the Islamic Republic of Iran is very low, and complete withdrawal of halothane might not be appropriate at present without comprehensive cost-effectiveness studies.
Why the study?
Should halothane be completely replaced by other inhalation anesthetics in a developing country setting?
Should halothane be completely replaced by other inhalation anesthetics in a developing country setting?
Complete withdrawal of halothane in developing countries like Iran may not be appropriate currently due to the low incidence of halothane hepatitis and the high cost of alternative anesthetics.
Answers are grounded in this paper and cite their sources.
May support retaining halothane in resource-limited settings; leaves open need for cost-effectiveness and safety studies before withdrawal.
The anaesthetic agent halothane is still widely used in developing countries including the Islamic Republic of Iran because of its low price. Because of halothane-induced hepatitis, a rare complication, it has been replaced by other inhalation anaesthetics in Western countries; it has been suggested by some Iranian professionals that the Islamic Republic of Iran should do the same. We evaluated various dimensions of this replacement through a literature review to assess the incidence of halothane-induced hepatitis and costs of anaesthetics in the country. We also conducted a questionnaire survey of 30 anaesthesiology/gastroenterology experts about their views on the subject. The results indicate that the incidence of halothane hepatitis in the Islamic Republic of Iran is very low and could mostly be avoided by strict adherence to guidelines. Complete withdrawal of halothane in the Islamic Republic of Iran might not be appropriate at present. Comprehensive cost-effectiveness studies are needed before a decision is made on complete replacement of halothane with other anaesthetics.
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Mahboobi et al. (2012) conducted a review in Halothane-induced hepatitis (n=30). Halothane vs. Other inhalation anaesthetics (isoflurane, sevoflurane, desflurane) was evaluated on Incidence of halothane hepatitis and expert consensus on its withdrawal. The incidence of halothane hepatitis in the Islamic Republic of Iran is very low, and complete withdrawal of halothane might not be appropriate at present without comprehensive cost-effectiveness studies.
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