LIVER-FUNCTION AND HALOTHANE-DIETHYL-ETHER AZEOTROPE ANESTHESIA - REEVALUATION OF AN OBSOLETE DRUG WITH SPECIAL REFERENCE TO EARLY POSTOPERATIVE EFFECTS

A general anaesthetic drug that fulfils requirements for use under dif ficult circumstances is the inhalation agent halothane-diethyl-ether ( HE) azeotrope. Although both halothane and diethyl ether have been des cribed in detail, their effect on the liver when given together as an azeotrope has not been systematically characterised. The effect on liv er function was evaluated and compared with the effects of halothane a naesthesia (H) and spinal anaesthesia with tetracaine (S), the last na med serving as controls. The series consisted of 33 healthy men (ASA 1 -2) receiving no medication and scheduled For inguinal hernia repair. The patients were randomly allocated to receive HE, H or S. The follow ing parameters were estimated the day before surgery and on the first postoperative day: liver cell metabolism (bile acids, unconjugated bil irubin), cell integrity (aminotransferases), synthesizing capacity (pr othrombin complex), cholestasis (conjugated bilirubin, alkaline phosph atase, gamma-glutamyl transpeptidase), and global liver function (chen odeoxycholic cholic load test). No major differences emerged between t he groups. Conjugated bilirubin was increased in all groups. Prothromb in complex activity was reduced in all groups. Conjugated bilirubin H as increased in the H group. The oral bile acid load test and the fast ing bile acid were unaltered by anaesthesia in all groups. So major im pact on liver cell function was seen in the early post-operative perio d after HE azeotrope anaesthesia. The findings support our view that H E azcotrope could be considered as an alternative anaesthetic agent un der field conditions.