Recurrent Hepatitis in Patients Receiving Multiple Halothane Anesthetics for Radium Treatment of Carcinoma of the Cervix Uteri

Abstract

Severe acute hepatocellular jaundice occurred in 6 women who had received multiple halothane anesthetics for radium treatment of carcinoma of the cervix uteri at the Queensland Radium Institute between March 1964 and October 1966. In 5 of the 6 patients recurrent episodes of otherwise unexplained fever, bilirubinuria, or jaundice followed separate exposures to halothane. Two patients died in acute hepatic coma. Treatment of this carcinoma has not been altered significantly in this center in the past 12 years except for the introduction of halothane as the anesthetic of choice in 1961. Most patients receive two or sometimes three radium insertions at weekly intervals under general anesthesia. No case of acute hepatocellular jaundice occurred in this unit before 1961 or after 1966. The use of halothane as an anesthetic for radium insertions was stopped in October 1966; since then an additional 320 patients have been treated without a further instance of hepatocellular jaundice. Fever developing later than the 5th postoperative day after an anesthetic was significantly more common after the use of halothane than other anesthetic agents. A prospective study of 50 patients receiving multiple nonhalothane anesthetics for radium treatment of carcinoma of the cervix uteri revealed none with late postoperative fever and no biochemical or clinical evidence to indicate liver damage.