Halothane and Liver Failure

Richard Aach, MD; Stanford Wessler, MD; Louis V. Avioli, MD
JAMA. 1970;211(13):2145-2147. doi:10.1001/jama.1970.03170130041008.
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Dr. John Bullock, Intern in Medicine, Jewish Hospital of St. Louis, and Assistant in Medicine, Washington University School of Medicine: A 62-year-old white woman was admitted to the surgical service on March 3, 1969, for an elective cholecystectomy. The patient was known to have had symptomatic gallstones since 1966. There was no prior history of liver disease, transfusions, excessive alcoholic intake, or exposure to individuals with jaundice or hepatotoxins. The day after admission the patient underwent cholecystectomy with halothane and nitrous oxide anesthesia. A 20-minute episode of hypotension occurred during the operative procedure at which time the blood pressure was less than 100/60 mm Hg and as low as 80/50 mm Hg. On the second postoperative day, in association with continuous coughing, wound dehiscence and colonic perforation occurred. Repair of the colonic perforation and colostomy were performed with the patient under spinal anesthesia and five minutes of halothane inhalation. Postoperatively,


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