Liver Necrosis Following Anesthesia

LIVER DYSFUNCTION, and even massive liver necrosis, has been linked1-10with the use of the potent, nonexplosive, volatile anesthetic agent, halothane (Fulothane—2-bromo-2-chloro-1,1,1-trifluoroethane) since its introduction in 1956. Previous reports of liver dysfunction following anesthetics were infrequent. A large combined study11between the years 1948 and 1952 of 599,548 patients indicated an anesthetic death rate of 1 in 1,560. No instances of death from hepatic necrosis occurred. Animal and clinical studies12-17of halothane revealed frequent liver dysfunction. The incidence in humans was nearly 50% according to laboratory data. These abnormalities were always mild and often present in only one of a battery of liver function tests. The control series using ether, cyclopropane, or unspecified anesthesia had equal changes. Clinical evidence of hepatic necrosis was rare, and no deaths were reported due to liver or renal failure. The present study is a review of all patients who developed icterus