Halothane and enflurane are halogenated hydrocarbons used as inhalation anesthetics. These agents may be associated with a drug-induced hepatitis that can be fatal. As a result these agents are used less frequently today, in favor of alternative agents.


Implicated anesthetics:

(1) halothane

(2) enflurane

(3) isoflurane

(4) methoxyflurane


Syndromes that may occur:

(1) transient elevation of transaminases, variable jaundice and low morbidity

(2) fulminant hepatitis with fever and high mortality


Risk factors for fulminant hepatitis:

(1) repeated exposures in a short period of time

(2) obesity


Both patients and operating room personnel are at risk.


Differential diagnosis:

(1) viral hepatitis

(2) sepsis

(3) hypoxic damage to the liver


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