G.G. Harrison

Hyperpyrexia During Anaesthesia

Work in pigs has shown that malignant hyperpyrexia during anaesthesia may occur without suxamethonium having been given. A virtually constant feature in reported cases and in our own observations is that all subjects developing hyperpyrexia had received nitrous oxide and halothane.

Pig Liver Perfusion in the Treatment of Fulminant Hepatic Necrosis

This paper describes 4 patients with hepatic coma resulting from presumed viral hepatitis with massive liver cell necrosis, who were treated with pig liver perfusion alternating with exchange transfusion. None of the patients survived, but two showed a response to the program of treatment employed, in that there was an improvement in the level of consciousness. All patients died of haemorrhagic complications. The contribution of the oxygenator used in the circuit to the development of thrombocytopoenia is discussed, with reference to other circuits with and without oxygenators. Thrombocytopoenia may also result from disseminated intravascular coagulation in the patient, and from sequestration of platelets in the liver perfused with heterologous blood.

Multiple Halothane Exposure and Hepatic Bromsulphthalein Clearance

Multiple exposures to halothane have been shown to have delayed effects on bromsulphthalein (B.S.P.) clearance. Rats were exposed to repeated halothane anaesthetics, and their livers were subsequently isolated and perfused. B.S.P. retention in the perfusate of these isolated livers was greatly increased one to three weeks after the last halothane exposure. In similarly pretreated animals at the same time period the B.S.P.—glutathione conjugating enzyme activity in homogenates of the livers was found to be depressed. These findings did not occur after multiple diethyl ether exposures or following a single exposure to halothane.

MULTIPLE HALOTHANE EXPOSURE AND HEPATIC BROMSULPHTHALEIN CLEARANCE

Multiple exposures to halothane have been shown to have delayed effects on bromsulphthalein (B.S.P.) clearance. Rats were exposed to repeated halothane anaesthetics, and their livers were subsequently isolated and perfused. B.S.P. retention in the perfusate of these isolated livers was greatly increased one to three weeks after the last halothane exposure. In similarly pretreated animals at the same time period the B.S.P.-glutathione conjugating enzyme activity in homogenates of the livers was found to be depressed. These findings did not occur after multiple diethyl ether exposures or following a single exposure to halothane.