Halothane and Liver Dysfunction: a Retrospective Study

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Abstract
A retrospective comparison between the effect on the liver of halothane and non-halothane anesthesia, as defined, was carried out in the United Cardiff Hospitals for the years 1960-62 inclusive. There were no statistical differences in the postoperative stay in hospital and in the mortality between these 2 groups. The result of liver-function tests performed within 28 days of an operation were analysed. The tests were compared for each anesthetic and for site of operation. There were no statistical differences between halothane and non-halothane. The clinical records of these patients were studied individually, without knowing which anesthetics had been used. A small group of patients had tests indicative of postoperative hepatic dysfunction, the cause of which was not easily ascertainable. These patients were distributed according to their anesthetic in proportion to the total number of each anesthetic. The morbidity in the group appeared to be random and not particularly related to anesthetic or indeed to any other factor. A separate clinical and statistical study made of deaths occurring within 28 days of anesthesia and operation. The clinical records, and the postmortem findings including the liver weights, were studied. Only in one case could the post-mortem macroscopic or microscopic finding of an abnormal liver not be explained by the clinical history. This patient had acute hepatic necrosis after a non-halothane anesthetic. No other consistent differences were found between the deaths which followed halothane and those after non-halothane. Out of 15,747 halothane and 6,123 non-halothane anesthetics there does not appear to be any important differences in the effect on the liver between halothane and non-halothane. It is unlikely that there is a graduated response on the liver related to dose. The authors found no evidence to show whether halothane produces a specific toxic effect or allergic reaction on patients with an inborn or acquired susceptibility to this agent, or indeed to any other anesthetic. However, if this is so, the incidence is less than could be discovered in a series of this size. This retrospective investigation would enable a prospective trial to proceed without ethical objections.