To the Editor.—
Methoxyflurane, halothane, and their metabolites have been reported to cause adverse reactions, primarily in the form of liver injury.1,2 Cross-sensitivity between these agents has also been reported.3 Even though serious adverse reactions are rare, fatalities ascribed to these agents seem to have occurred.Enflurane (Ethrane), a newer anesthetic agent, has become widely used with considerable safety. It is not entirely unexpected, though, that liver injury would sooner or later follow.In the following case, an adverse reaction to enflurane may have occurred.
Report of a Case.—
A 62-year-old diabetic woman with a complaint of right upper abdominal pain underwent cholecystectomy for cholecystitis with cholelithiasis. A liver biopsy specimen obtained at surgery showed unsuspected cirrhosis. The patient, who had no previous exposure to halothane or enflurane, received enflurane, sodium pentothal, curare, and succinylcholine. There was no history of previous viral hepatitis or hepatitis contact. On admission,
van der Reis L, Askin SJ, Frecker GN, Fitzgerald WJ. Hepatic Necrosis After Enflurane Anesthesia. JAMA. 1974;227(1):76. doi:10.1001/jama.1974.03230140046014
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