ABSTRACT

Hepatic injury is a recognized phenomenon following volatile anesthetic exposure, particularly after halothane administrations and, to a lesser degree, other volatile anesthetics. The hepatotoxicity associated with these anesthetics is sometimes fatal and always unexpected. The sporadic nature of this injury has initiated extensive research to determine its mechanism, and major efforts are under way to produce a representative animal model. Neither phenobarbital pretreatment nor exposures in hypoxic atmospheres are required for the production of the hepatotoxicity. The injury is more prevalent in females and in heavier, older animals. Although anesthetic-induced hepatotoxicity may be initiated by direct or metabolite-mediate process following halothane exposure, this liver injury may also be the result of an immune-mediated process. However, the association between halothane-induced liver injury and an immune response directed toward a metabolite-altered hepatocyte protein has been under scrutiny for several years with ambiguous results.