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Elevated serum bromide concentrations following repeated halothane anaesthesia in a child
1Department of Anesthesiology, Children's Hospital, Denver, Colorado 80218.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|October 1, 1990
Summary
Repetitive halothane anesthesia in a child with ependymoma led to elevated serum bromide levels, suggesting potential bromide intoxication. Monitoring is crucial for pediatric neuro-oncology patients undergoing anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Oncology
- Clinical Chemistry
Background:
- A pediatric patient with posterior fossa ependymoma required multiple general anesthetics.
- The treatment involved 25 brief halothane exposures over five weeks for cranial irradiation.
Observation:
- Personality changes in the patient prompted investigation for possible bromide intoxication.
- Serum bromide levels were monitored during and after the anesthesia protocol.
Findings:
- Serum bromide concentrations showed a four-fold increase, peaking at 2.2 mEq.L-1 during the final week of treatment.
- Levels decreased to below 0.5 mEq.L-1 six weeks post-treatment, indicating bromide accumulation and subsequent clearance.
Implications:
- Repetitive, short-duration halothane anesthesia can lead to elevated serum bromide levels.
- Pediatric neuro-oncology patients receiving repeated anesthesia may be at risk for bromide intoxication.
- Clinical monitoring for bromide levels is recommended in this vulnerable patient population.