Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The volatile halothane metabolites, 2-chloro-1,1,1,-trifluoroethane and 2-chloro-1,1-difluoroethylene, were identified in the exhaled breath of ten children during halothane anaesthesia. Although there was considerable variation among children in the concentration and time-course of metabolite exhalation, exhaled concentrations of these metabolites were of a similar magnitude to those reported in adults. This result suggests that the lower incidence of halothane hepatitis in children compared with adults is not due to a poor ability to metabolise halothane by the reductive pathway.
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PMID:Reductive metabolism of halothane in children. 651 87

We present a case of halothane-associated-hepatitis in a 34-year-old woman. She received halothane anesthesia twice within a 6-day interval, 2 weeks prior to the onset of symptoms. Liver histology was nonspecific, and unusual in showing not only lobular hepatitis but also granulomatous changes. Since the clinical picture and the laboratory values were more and the liver histology less in keeping with the diagnosis, we emphasize that the former two parameters should play a vital role in establishing or discarding the diagnosis of halothane-induced hepatitis.
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PMID:Halothane-associated granulomatous hepatitis. 667 85

The effect of immunologic hypersensitivity to a metabolite of halothane (trifluoroacetate) on the halothane-hypoxia-induction model was tested in mice and rats. Male Fisher 344 rats (200 g) were immunized with ovalbumin-trifluoroacetate (OVA-TFA) and the time course of the delayed hypersensitivity response determined. The animals had a peak response between 4 and 6 weeks after immunization. Rats were immunized with OVA-TFA, OVA, or saline 5 weeks before being anesthetized. Ten days before anesthesia, the animals were started on 0.1% phenobarbital in the drinking water. The animals were anesthetized with 1% halothane and 14% oxygen for 2 h. Hypersensitivity to TFA had no effect on the liver damage in either the mouse or the rat. These results do not rule out an immunologic vector in halothane hepatitis but make the involvement of TFA unlikely.
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PMID:Effects of hypersensitivity to a halothane metabolite on halothane-induced liver damage. 669 35

A retrospective questionnaire revealed 11 patients with halothane related liver disturbances in Finland in 1972-1981. Seven of the cases were regarded as obvious and two as probable halothane hepatitis (HH). Four patients suffered HH twice, and none of the cases had a fatal outcome. The speed of onset of icterus correlated with the number of halothane exposures, as did the increase in liver enzyme (ASAT, ALAT) activities and the increase in serum bilirubin concentration. Halothane anaesthesia is strictly contraindicated if a nondefinite icterus has appeared after a previous exposure to halothane. It should not be given if unclear fever or prolonged nausea have followed a previous exposure. No major adverse effects or organ toxicity connected with enflurane were found.
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PMID:Liver damage after halothane anaesthesia: analysis of cases in Finnish hospitals in 1972-1981. 673 54

A 12 year old boy with Burkitt's lymphoma developed severe hepatitis with hepatomegaly, subclinical jaundice, and a small rise in body temperature, associated with an important rise in SGPT and fall in prothrombin titres, 6 days after anticancer chemotherapy and 24 hours after halothane anaesthesia. Hepatitis A and B serology remained negative. This hepatic failure explained perhaps the unusually severe vincristine toxicity which gave rise to a polyneuritis with important sequelae. The association of halothane hepatitis with antimitotic drugs appeared particularly dangerous, and halothane should probably be avoided in all patients been given or about to be given anticancer chemotherapy.
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PMID:[Post-anesthetic hepatitis. The role of halothane and antimitotic combinations]. 674 42

At the Hospital for Sick Children, Great Ormond Street, during the 23-year period 1957 to 1979, 165400 anaesthetics were administered. Almost all of the patients anaesthetised during this time would have been exposed to halothane. Seventy-four patients became jaundiced for the first time in the post-operative period. Halothane-associated hepatitis was excluded as the cause of the postoperative jaundice in all but two of the 74 patients. In these two patients in whom the diagnosis of halothane-associated hepatitis was possible the hepatitic illness was mild and both patients made an uneventful recovery. In this survey the risk of a patient becoming jaundiced due to halothane associated hepatitis was greater than 1 in 82000. It would seem that in children halothane can be used whenever it is warranted and can be used repeatedly.
Anaesthesia 1983 Mar
PMID:Postoperative jaundice in children. The influence of halothane. 683 1

Analysis of 24 cases of enflurane anesthesia-associated hepatic injury shows that the clinical, biochemical, and histologic features are similar to those seen with halothane- and methoxyflurane-related hepatitis. Postoperative fever was the presenting symptom in 19 patients. Jaundice occurred in 19 patients after a mean latent period of 8 days. Sixteen patients had been previously exposed to enflurane or halothane, and the latent period from exposure to the onset of symptoms or jaundice was shortened in these patients. There were five fatalities among the entire group. Liver biopsy most characteristically showed centrilobular necrosis, occasionally with ballooning degeneration and fatty change. The presumed mechanism of injury is metabolic idiosyncracy, and prior exposure to a haloalkane anesthetic may increase the risk of hepatic injury after enflurane administration.
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PMID:Enflurane hepatotoxicity. A clinicopathologic study of 24 cases. 685 8

General anesthesia offers greater comfort for both the abortion patient and the operator. The combination of diazepam and ketamine which is rapidly reversible and offers a moderately deep anesthesia was used in 127 voluntary abortions and 3 therapeutic abortions. Patients ranged in age from 14-40 years and averaged 26, with 58% under 26. Patient weights ranged from 40-82 kg and averaged 56 kg. 43% were primaparas and average parity was 2.5. The average duration of the prenancy was 8.1 weeks. 10 patients were obese, 1 was asthmatic, 1 was a controlled hypertensive, 3 had cardiopathies, and 4 each had hepatitis and meningitis. 1 had treated epilepsy and 2 had serious depressive syndromes. 3 women had previously had voluntary abortions, 9 had had miscarriages, and 1 had had an extrauterine pregnancy. 17% had no fear or anxiety before the procedure, 56% had moderate levels, 28% had significant levels, and 19% had very high levels. 94% of the procedures were done by aspiration and in most cases a preliminary insertion of laminaria was done. The average duration of the procedure was 5 minutes, with extremes of 2 and 25 minutes. Patients were premedicated 1 hour before the procedure with intramuscular injections of 10 mg diazepam and 1/4 mg of atropine. For the induction, a butterfly needle with an antireturn system was used to inject 10 mg of diazepam and 1/4 mg of atropine diluted in 20 ml of distilled water. The patient was placed in the gynecological position and, if necessary, 5 mg of diazepam were added. Between .5-1 mg/kg of ketamine were injected in 10-15 seconds. The same dose was reinjected if the anesthesia was insufficient or the procedure was prolonged. A mixture of 40% oxygen and 60% nitrous oxide was administered if necessary. Patients remained in bed for 6 hours after awakening. 85% of patients received total doses of ketamine of .70mg/kg or less. Average duration of anesthesia was 9.2 minutes, with durations of less than 15 minutes in 94% of cases. On awakening 5% of patients had nausea and vomiting. 16% had minor psychic disturbances or disorientation, 8% had moderate problems with vocalization, and 2% had hallucinatory delirium with agitation. Overall, 20% of patients experienced headaches, 11% nausea, and 9% dizziness. It was concluded that the combination of diazepam .2 mg/kg and ketamine .5-.7 mg/kg provides well tolerated light anesthesia utilizable for outpatient abortions.
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PMID:[Diazepam and ketamine for voluntary interruptions of pregnancy]. 692 72

Patients with liver disease have increased morbidity and mortality following general anesthesia and surgery when compared with the general population. The increase in mortality appears to be directly related to the severity of hepatic parenchymal cell failure and to the magnitude and duration of the surgical procedure. The importance of preoperative detection of subclinical liver disease by use of a variety of blood tests has been emphasized. However, with the exception of hepatitis B and non-A non-B hepatitis, a precise diagnosis of the exact cause of liver disease is usually less important to the anesthesiologist than is a full characterization of the severity of hepatic dysfunction. Recognition and understanding of the central metabolic role played by the liver in maintaining carbohydrate, fat, and protein homeostasis can help in predicting and managing abnormalities which may complicate the preoperative, interoperative, and postoperative periods. Liver failure after anesthesia and surgery is treated by the same management principles used for liver failure with acute hepatitis. The incidence of postoperative renal failure may be increased in patients who have severe hyperbilirubinemia and its occurrence should be differentiated from the hepatorenal syndrome. It should be understood that complications of portal hypertension may develop in the absence of overt hepatic parenchymal cell failure and that liver failure may occur without gross evidence of portal hypertension. Either situation must be recognized and treated as far in advance of surgery as possible. In general, elective surgery in the patient with liver disease should be delayed until consequences of hepatic parenchymal cell dysfunction and portal hypertension are optimally corrected.
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PMID:Medical evaluation of the patient with liver disease prior to surgery. 701 90

With an attempt to diminish the post-transfusion hepatitis following radical hysterectomy, the study was made on 27 cases of cervical cancer undergone the operation. Fifty cases with blood transfusion immediately prior to the study was taken as control group. Under general anesthesia, 800 ml of venous blood was drawn from the peripheral vein under simultaneous infusion of 1,000 ml of Saviosol to maintain the circulating blood volume. The blood was returned after hemostatizing procedures. Of the study group, the blood loss, operation time, urinary output during the operation, and drainage amount were 960 g, 157 minutes, 350 ml and 160 ml respectively, while those of control group were 930 g, 164 minutes, 150 ml and 280 ml. The circulation status remained within normal limits, no bleeding tendency was appeared. Blood loss of the study group was estimated 960 g, however the actual blood loss calculated was on l6 719 g. There were no particular complication in the study group, while there was 12% of hepatitis among the control group. The advantages were concluded as 1) Patient was under normovolemic state when the operation started. 2) The blood transfused had normal O2 transport and hemostatic capacity. 3) The management of the patient was not so difficult and no special equipment and technique were needed.
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PMID:[Acute preoperative hemodilution in radical hysterectomy for carcinoma of the uterine cervix (author's transl)]. 710 7


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