Halothane and liver damage.

Halothane was first synthesized by Suckling in 1952 and introduced into clinical practice a few years later.',2 Its many advantages, such as quick action, easy administration, non-explosiveness, high potency and low cost, led to its widespread use within a short time. Although initial animal work did not indicate any hepatotoxic effect,3`5 the first cases of unexplained hepatitis after exposure to halothane were reported only two years after its introduction into clinical use.6'7 During the following years an increasing number of reports dealt with the association between halothane exposure and liver damage.8"'6 Despite the accumulation of clinical evidence, there was still considerable disagreement regarding this association. The controversy was based on whether post-anaesthetic hepatic dysfunction could be attributed only to halothane or also to other anaesthetic agents. Early clinical research also failed to show a significant rise in the frequency of liver damage following exposure to halothane, compared with other anaesthetic agents in use.11'1724 The difficulty in proving an association results from the rarity of the phenomenon on the one hand, the widespread use ofthe agent on the other and the many other reasons for fever and jaundice following surgery.25 Only during the 1960s and since have sufficient data accumulated to prove the existence of 'halothane hepatitis'.22'26-29