Massive Hepatic Necrosis after Fluroxene Anesthesia — A Case of Drug Interaction?

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Abstract
THE inhalation anesthetic fluroxene (Fluoromar, 2,2,2,-tri-fluoro-ethyl vinyl ether), has just been considered hepatotoxic.1 Recently, a patient taking phenobarbital and diphenylhydantoin died of massive hepatic necrosis after fluroxene anesthesia – conditions suggestive of an acquired enhanced sensitivity to the anesthetic.2 Case ReportAn obese 69-year-old woman with grand-mal epilepsy since the age of 15 that had been effectively controlled with diphenylhydantoin (Dilantin), 300 mg per day, and phenobarbital, 120 mg per day, had also received phenylbutazone (Butazolidin) for osteoarthritis. At 65 years of age a gastric ulcer was treated conservatively. Four months before admission ulcer symptoms recurred, 1 week before she . . .