[Comparison of hepatic enzymes level between operating room's staff and other wards' personnel]

Long exposure to inhalant anesthetic gases especially halothane, among the known hepatotoxic agents, is a serious health risk for the staff of operating room. Current study was performed to compare the level of hepatic enzymes between Operating's room staff and other therapeutic wards' personnel out of the operating room. A total of 100 personnel from educational hospitals were included and their demographic and occupational information were recorded. Hepatic function tests and bilirubin were analyzed. In cases with values more than normal, in order to rule out hepatitis B and C, Hbs-Ag, Hbs-Ab and HCV-Ab were tested. Demographic information and employment span were comparable in two groups. The average of ALT, AST were significantly higher among operating room's staff in comparison with the other group [P<0.05] and there was no significant difference between the average of GGT and ALP between two groups [P>0.05]. ALT, AST and GGT indicated significantly increase with the age of personnel [more than 40 years] and increase in employment period [more than 15 years]. The operating room's staff in educational hospitals of Ardabil may be exposed to hepatotoxic agents that caused significant rise in hepatic enzymes

[Comparison of hemoglobin concentration, after cesarean .section, between two methods: general anesthesia and spinal anesthesia]

The use of halogenated agents during balanced general anesthesia may result in an increase in blood loss associated with cesarean section but in some studies this result rejected. The aim of this study was. Comparison of hemoglobin concentration, after cesarean section between two methods: general anesthesia and spinal anesthesia. This clinical trial study comprised 170 pregnant women, who were elective cesarean section candidates for the second time. This study was approved by the local committee of medical ethics. Patients were randomly divided into two groups, each with 85 members. Exclusion criteria were: cardiac diseases, coagulate disorders, anemia, preeclampsia, abruptio placenta, emergent cesarean section cases, atonia [polyhydramnius ....], birth weight more than 4kg, and long duration of the operation [more than 90']. Patients of the first group underwent general anesthesia and spinal anesthesia was applied for the second group. There was no significant difference between both groups regarding the mean age, operation, and anesthesia durations [p>0.05]. The mean hemoglobin [HP] and hematocrit [Hct] levels were significantly lower in both groups post operatively compared with the same values pre operatively [p<0.05]. Post operative, Hb.Hct reduction rate [preoperative Hb.Hct minus post operative Hct] was significantly higher in general anesthesia group [p<0.05]. If duration of operation time was longer than one hour, Hct significantly decreased. Results of the present study showed that postoperative Hct reduction rate in cesaeran section was higher in patients who received general anesthesia in comparison with spinal anesthesia

Effect on free radical generation with different anaesthesia.

Reactive oxygen species are a part of the normal physiology of the biological system but their subsequent defence undergoes alteration during diseased conditions. Administration of anaesthesia for surgery may also alter the formation of reactive oxygen species. The present work deals with the comparative status of oxidative stress (lipid peroxidation) and anti-oxidant defence markers (superoxide dismutase and catalase) in blood in 3 groups of 15 patients each receiving halothane, relaxant vecuronium and spinal form of anaesthesia with lignocaine 5% heavy. The results obtained depict that the formation of malonyl dialdehyde as well as decrease in superoxide dismutase and catalase activities was highest in spinal anaesthesia followed by halothane and then relaxant group. Therefore, it seems important to consider the pre-operative anti-oxidant status while administering anaesthesia to such patients in order to provide biologically safe anaesthesia.

effect of halothane, isoflurane, sevoflurane and propofol infusion on renal function after coronary artery bypass surgery

Renal insufficiency after cardiac surgery is associated with increased mortality, morbidity, and length of stay in the intensive care unit. We investigated the effect of isoflurane, halothane, sevoflurane and propofol anesthesia on perioperative renal function following elective coronary artery surgery. The medical records of 224 patients, in the Hacettepe University Medical Faculty Hospital who had undergone cardiac surgery in one year, were retrospectively reviewed. 65 [29%] patients received isoflurane, 68 [30%] patients received halothane, 64 [29%] patients received sevoflurane, and 27 [12%] patients received propofol infusion as part of maintenance anesthesia for coronary artery bypass surgery. Patient characteristics [age, sex, preoperative ejection fraction], operative data [duration of CPB, duration of operation, number of distal anastomoses, usage of diuretic, intraoperative crystalloid and blood transfusion], intraoperative urinary output, preoperative and postoperative [6th hours and 24th hours] BUN and plasma creatinine levels, were not statistically significant between and within groups. Intraoperative inotropic agent [dopamine] was used in 8 [12.3%] patients in the isoflurane group, in 10 [14.7%] patients in the halothane group, in 11 [17.2%] patients in sevoflurane group and in 9 [33.3%] patients in the propofol group. Postoperatively fluid and blood transfusion, postoperative drainage, urinary output, diuretic usage were smiliar between the four groups [p>0,05]. Inotropic agent was used in 8 [12.3%] patients in the isoflurane group, in 9 [13.2%] patients in the halothane group, in 16 [25%] patients in the sevoflurane group and in 7 [25.9%] patients in the propofol group. It is concluded that, halothane, isoflurane, sevoflurane and propofol infusion anesthesia as part of anesthesia maintenance for elective coronary artery bypass surgery does not affect early postoperative renal functions

Nausea and vomiting after general anesthesia with halothane or isoflurane; A double blind randomized trial

Postoperative nausea and vomiting [PONV] is potentially dangerous and causes morbidity and excessive costs to the patients. Prior investigators have reported controversies about halothane- and isoflurane-induced PONV, thus, the present study was conducted to compare these two drugs. 80 candidates for elective minor orthopedic surgery were randomly allocated into two groups, halothane [n= 40] and isoflurane [n=40]. Confounding factors including sex, age, duration of surgery, NPO, history of general anesthesia, history of PONV, drugs, and history of disease were recorded in a questionnaire. PONV was assessed at three occasions [recovery, 3- and 6- hour post operative]. PONV was reported in 4 [10%] and 3 [7.5%] patients in halothane and isoflurane groups, respectively [NS]. None of the patients suffered PONV 3- or 6-hour post operative. Results revealed that the incidence of PONV can be held low, with an aggressive control of risk factors, in addition, halothane or isoflurane seems to have no preference from this aspect to each other

Estudo comparativo entre sevofluorano, halotano e isofluorano em Gallus domesticus / Comparative evaluation with sevoflurane, halothane and isoflurane in Gallus domesticus

Foram utilizados 30 frangos com 20 semanas de idade, pesando em média 2,90 ñ 0,65kg divididos aleatoriamente em três grupos. A induçäo da anestesia foi realizada com máscara facial artesanal conectada ao sistema de Maggil Modificado, utilizando entre 3,0 e 3,5 vezes a dose anestésica mínima (DAM) de cada agente e fluxo diluente de O2 de 2l/min, sendo que posteriormente os animais foram intubados e mantidos com valores de aproximadamente 1,7DAM durante 65 minutos. O isofluorano causou maior depressäo respiratória e hipotensäo; o halotano proporcionou maiores valores de pressäo arterial e temperatura corporal e o sevofluorano, menor depressäo respiratória e hipotensäo em relaçäo ao grupo do isofluorano, sendo considerado o agente mais indicado para a utilizaçäo em aves. A induçäo e recuperaçäo foram mais rápidas com o sevofluorano, embora sem diferença significativa estatisticamente.

Sevoflurane versus halothane for the incidence and type of arrhythmia during anaesthesia for adenotonsillectomy in children

This study was carried on 60 patients scheduled for adenotonsillectomy to compare the incidence and type of arrhythmia during sevoflurane or halothane anesthesia. All patients were premedicated with atropine 0.01-0.02 mg/kg im 30 minutes before induction of anesthesia, then received inhalation induction using nitrous oxide 50% in oxygen supplemented with either sevoflurane or halothane. Time to loss of eyelash reflex was more rapid with sevoflurane than halothane, although time to adequate anesthesia to allow the insertion of endotracheal tube was slower in sevoflurane group. The incidence of cardiac arrhythmia was higher during halothane [40%] than during sevoflurane anesthesia [20%] and the arrhythmia was more often ventricular in origin in the two groups

Evaluación química de un sistema de extracción de gases anestésicos residuales para el control de la contaminación en salones de operaciones / Chemical evaluation of a system for the extraction of residual anesthetic gases to control pollution in operating rooms

Se estudia la eficiencia de un sistema de extracción local de gases anestésicos residuales el cual fue propuesto con la finalidad de controlar, mediante un método sencillo y económico, la contaminación por este tipo de sustancias en los salones de operaciones del país

Effect of some anaesthetic agents and surgery on blood glucose, triglycerides, growth hormone, adrenocorticotrophic hormone and liver functions in humans

The present study was carried out to compare the effects of the most widely used inhalational anaesthetics in the form of nitrous oxide and oxygen or halothane and oxygen and regional analgesia using intrathecal bupivacaine on carbohydrate and fat metabolism. The study included the determination of blood glucose triglycerides and the hormones that affect their metabolism mainly growth hormone [GH] and adrencortictrophic hormone [ACTH] as well as the liver functions under the stress of minor operations. Thirty patients ASA 1 and II, were randomly divided into three groups, 10 patients in each group according to the type of anaesthetic. Venous blood samples were taken before induction of anaesthesia, during operation two hours after the end of surgery and on the third postoperative day. A significant increase in blood glucose was detected in the three groups and it remained significantly high in the nitrous oxide and halothane groups during the postoperative period. Plasma Gil increased significantly in the three groups and remained high in the immediate postoperative period and decreased to preoperative values on the third postoperative day. ACTH significantly increased in all three groups during operation and in the postoperative period However liver functions showed some changes but within normal levels. Therefore the rise of blood glucose, ACTH and GH indicates a stress response to anaesthesia and surgery especially in those receiving general anaesthesia hence it should be supplemented with analgesic agents as premedication, during induction of anaesthesia and during operation as well as in the postoperative period in order to obtund these stressful responses

Uso da soluçäo hipertônica de cloreto de sódio a 7.5 por cento no tratamento da hipotensäo arterial decorrente da anestesia com halotano em equinos / Treatment of halothane arterial hypotension in equines with the use of 7.5 per cent sodium chloride hypertonic solution

Soluçäo hipertônica de cloreto de sódio a 7,5 por cento tem sido utilizada no tratamento do choque hipovolêmico. Sua açäo é caracterizada pelo aumento do débito cardíaco, da pressäo arterial sistêmica e do volume plasmático. O objetivo deste estudo foi avaliar a açäo da soluçäo hipertônica de cloreto de sódio a 7,5 por cento (4 ml/kg) no tratamento da hipotensäo arterial induzida pela anestesia geral com halotano em equinos. Foram utilizados 15 equinos adultos, de ambos os sexos e raças e pesos variados, encaminhados a processos cirúrgicos eletivos. A técnica anestésica constituiu-se da sedaçäo com detomidina, induçäo anestésica com éter gliceril guaiacol, midazolam e quetamina e manutençäo anestésica com halotano em oxigênio. Estabeleceu-se como valor mínimo para infusäo de soluçäo hipertônica de cloreto de sódio a 7,5 por cento, pressäo arterial média inferior a 60 mmHg. Foram avaliados os seguintes parâmetros: frequência e ritmo cardíacos; pressäo arterial sistólica, diastólica e média; frequência respiratória; tempo de preenchimento capilar; gases sanguíneos, pH arterial, bicarbonato plasmático; saturaçäo da oxi-hemoglobina; concentraçäo plasmática de sódio e cloreto e hematócrito. Considerou-se o tempo zero como controle e os parâmetros foram aferidos aos 5, 15, 30 e 60 minutos após a infusäo. Verificou-se aumento significativo dos valores da pressäo arterial, a qual manteve-se elevada durante o período de observaçäo. Os valores do hematócrito diminuíram significativamente demonstrando ter havido expansäo volêmica. Houve discreta hipernatremia e hipercloremia. Os demais parâmetros permaneceram inalterados. Pode-se concluir que a soluçäo hipertônica de cloreto de sódio a 7,5 por cento mostrou-se efetiva, podendo ser utilizada com segurança nos processos hipotensivos desencadeados pela anestesia geral com halotano

Contaminación por halotano en el quirófano, con el uso de dos circuitos anestésicos: Circuito semicerrado y circuito semiabierto / Halothane pollution in operating room. a comparison using semiclosed and semiopen anesthetic circuits

Por cromatografía de gases, fue identificada y cuantificada la existencia de halotano en el área respiratoria del anestesiólogo y en la sangre del anestesiólogo, cirujano e instrumentista, durante el transcurso de un acto quirúrgico bajo anestesia general inhalatoria con halotano y el comportamiento de estos niveles durante una jornada de trabajo de 6 hrs, con el empleo de dos circuitos anestésicos: circuito semicerrado y circuito semiabierto. Los resultados muestran que los niveles de contaminación por halotano en el área respiratoria del anestesiólogo al final de una cirugía bajo anestesia general inhalatoria son similares con el uso de circuito semicerrado y semiabierto, siendo estos cuando menos 10 veces más altos que los valores permisibles por la NIOSH. Las concentraciones sanguíneas de halotano en el personal que integra el equipo quirúrgico son más altos cuando se utiliza el circuito semiabierto, y superan los niveles permisibles incluso para medio ambiente

Hipertermia maligna / Malignant hiperthermia

La hipertermia maligna (HM) es un desorden muscular de tipo hereditario, provocado por algunos agentes durante la anestesia, particularmente la asociación de halotano con succinilcolina. Este desorden puede tener, si no es detectado y tratado a tiempo, una evolución fatal. La frecuencia descrita es de 1:14,000 en niños y 1:40,000 en adultos. El presente trabajo tiene la intención de tocar los aspectos generales de esta entidad, así como detectar las situaciones en que pudiera sospecharse el desarrollo del mismo, al igual que el tratamiento de este raro pero fulminante desorden muscular relacionado con la anestesia

Estudo comparativo sobre sevoflurano e halotano na induçåo e manutençåo de anestesia pediátrica ambulatorial / A comparative study of sevoflurane versus halothane dor induction and maintance of anesthesia in pediatric outopatients

Background and objectives - Sevoflurane is a new anhalational agent with low blood solubility which provides rapid induction and recovery, desirable characteristics in outpatient anesthesia. The aim of this study was to compare sevoflurane and halothane regarding quality of induction, cardiovascular stability and characteristics of post-anesthetic recovery in pediatric outpatients. Methods - Forty-one physical status ASA I pediatric outpatients were allocated into two groups, as they received sevoflurane or halothane in N2O/O2 (50/50 per cent) for induction and maintenance of anesthesia. Orotracheal intubation was performed after a sigle dose of succinylcholine. Monitoring throughout the study included PET CO2, ET N2O, ET O2, ET SEVO, ET HALO, SBP, DBP and HR. Results - Exposure time to the anesthetics were similar in both groups. There were no significant differences in induction times between the groups. Times to eye opening, to obey command, to orientation, and to discharge from phase I recovery were significantly shorter in the sevoflurane group as compared to the halothane group. Time to discharge from phase II recovery was also shorter in the sevoflurane group, although not statistically significant. The incidence of adverse effects was similar in both groups. Cardiovascular stability was good with both agents. Conclusions - The smooth and rapid induction, the good cardiovascular stability and the relatively low incidence of adverse effects make sevoflurane a good anesthetic for pediatric outpatients. The results of thie study regarding postanesthetic recovery time indicate some advantage of sevoflurane over halothane. Nevertheless, the early arousal causes intense pain perception soon after discontinuation of the anesthetic, thus requiring an effective method of postoperative analgesia

Hepatitis fulminante por halotano: informe de dos casos clinicopatológicos / Fulminant hepatitis by halothane: report of two clinicopathological cases

El halotano fue introducido por primera vez en la práctica clínica en 1956 y desde entonces se ha informado sobre muchos casos de daño hepático posterior a la exposición a este halogenado. Su incidencia es de uno por cada 10,000 anestesias con halotano, pero después de múltiples exposiciones la frecuencia aumenta a siete por cada 10,000 anestesias. No obstante, la hepatitis fulminante asociada a halotano es baja, a pesar de su gran uso (uno por cada 35,000 anestesias). Los hallazgos histológicos en hígado son: presencia de necrosis submasiva a masiva de predominio centrolobulillar e infiltración grasa (esteatosis). El primer caso registrado en el Hospital General de México fue en el año de 1972. En el presente informe se presenta dos casos clinicopatológicos de hepatitis fulminante por halotano, posterior a la primera exposición a este agente anestésico

Effect of halothane exposure on motor skills & memory in anaesthetists.

In a prospective study involving 24 anaesthesia residents, each resident was assessed three times i.e., first as control group, not exposed to anaesthesia at all; the second group in which the resident was exposed to anaesthesia while using controlled respiration with closed circuit without halothane (non-halothane group) and the third group in which they were exposed to anaesthesia using spontaneous respiration with semiclosed circuit using halothane (halothane group). After each exposure of 3-4 h duration in each group, the resident was subjected to specific psychological tests to assess motor skills and memory. In the non-halothane group, a depression of motor skills by 5.51 per cent and of memory by 17.14 per cent was observed. In the halothane group, the reduction of motor skills was up to 27 per cent and of memory by 45 per cent as compared to the control values. It is concluded that 3-4 h exposure to halothane (1.5-4%) obtunds the motor skills and memory in anaesthetists.