Hepatotoxic effects of repeated anaesthetics.
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Chemical and Drug Induced Liver Injury↗
Biomedical subjects
G W Black
Publications and source records attributed to G W Black.
Methodology of a prospective study of changes in liver enzyme concentrations following repeat anaesthetics.
The methodology of a large prospective study on the influence of repeated anaesthetics on liver function is reported and the problems involved are discussed. The most suitable patients were those presenting for endoscopic examination of the bladder and urethra, for urethral dilatation and for cervical implantation of radium. Blood samples were taken immediately before induction of anaesthesia and on days 3-4 and 13-15 after operation, when a clinical assessment of the patient was also carried out. The concentrations of six enzymes (lactate dehydrogenase, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, serum cholinesterase and gamma glutamyl transpeptidase) werechosen specifically as indices of liver function. The eosinophil count was measured to reflect any hypersensitivity reaction. The non-Gaussian distribution of these necessitated using appropriate non-parametric tests together with parametric tests on logarithmic transformed data. In addition a quantal method was used to measure the frequency of patients showing an "abnormal" increase in enzyme concentrations.
Anesthesia, Inhalation↗
A prospective study of liver enzyme and other changes following repeat administration of halothane and enflurane.
A prospective study of liver enzymes and other measurements following repeat administrations of halothane or enflurane was carried out in patients undergoing minor urological operations. The patient populations were similar with respect to frequency of factors which might influence liver function, social habits, drug therapy and time intervals between administrations. Sixty-three received two or more administrations of halothane and 66 received two or more administrations of enflurane, both drugs given with nitrous oxide in oxygen. There was a greater frequency of increased enzymatic activity following repeat administrations of halothane than following enflurane and the average alanine aminotransferase and gamma glutamyl transpeptidase concentrations were increased to a greater degree following halothane than enflurane. There was no change in the eosinophil count and no significant postoperative morbidity. Change in alanine aminotransferase, lactate dehydrogenase and gamma glutamyl transpeptidase occured more frequently in obese patients receiving halothane.
Aged↗
Enflurane.
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Abnormalities, Drug-Induced↗
Liver function following repeated anaesthesia--method of study and interim results.
Preliminary analysis of a yet incomplete prospective study of liver enzyme changes following anaesthesia shows less changes following repeated administration of enflurane than of halothane.
Anesthesia, Inhalation↗
Estimation of blood enflurane concentrations by gas-liquid chromatography.
A simple and reliable method for the estimation of enflurane concentrations in whole blood is described. This involves exraction with n-heptane and estimation by gas-liquid chromatography using methoxyflurane as an internal standard. Reproducibility was good and extraction from whole blood was reliable.
Chromatography, Gas↗
Clinical impressions of enflurane.
Enflurane was used in 150 non-selected patients and was found to be a most satisfactory inhalation anaesthetic. Induction and recovery times were rapid and these characteristics, together with its rather pleasant smell, made it readily acceptable to the patient. Although such features suggest that it would be an ideal agent for children, very high concentrations of enflurane were required to produce adequate anaesthesia in infants and small children. Normal sinus rhythm continued following the injection of adrenaline during enflurane anaesthesia and adequate muscle relaxation was obtained for lower abdominal surgery. The degree of metabolic breakdown of enflurane is considerably less than with other inhalation agents and, if this is reflected in terms of minimal renal and hepatic toxicity, there is every reason to believe that enflurane may be preferable to the volatile anaesthetics currently in use.
Adolescent↗
Behavioral clusters and coronary heart disease risk.
The purpose of the present study was to empirically identify individuals who differed in their patterns of components derived from the structured interview (SI), and to evaluate whether individuals characterized by the different patterns varied in terms of their risk for coronary heart disease (CHD). The present study represents a reanalysis of data from the Western Collaborative Group Study in which components of Type A were individually related to risk for CHD. Subgroups of individuals who differed in the patterns of their component scores were identified by means of cluster analytic techniques and were found to vary in their risk of CHD. As expected, a pattern of characteristics in which hostility was salient was found to be predictive of CHD. Moreover, another pattern of characteristics that appears to reflect pressured, controlling, socially dominant behavior in which hostility was not salient also was found to be predictive of CHD. Further, two patterns of characteristics were identified that were unrelated to CHD risk. Finally, two patterns of characteristics were identified that were related to reduced risk of CHD. Overall, these results suggest that future research should investigate variables in addition to hostility in regard to risk for and protection from CHD.
Adult↗