Halothane and children: the first quarter century

Area of Science:

• Anesthesiology
• Pediatric Anesthesia
• Pharmacovigilance

Background:

• Halothane has been the primary anesthetic at Children's Hospital, Columbus, Ohio for 25 years.
• Previous observations suggested rare adverse reactions to halothane in pediatric patients.

Purpose of the Study:

• To confirm the impression of rare adverse reactions to halothane in children.
• To evaluate the safety profile of halothane in a large pediatric cohort.

Main Methods:

• Retrospective review of 200,311 cases using halothane.
• Analysis of life-threatening complications and potential contributing factors.

Main Results:

• Fifteen patients experienced life-threatening complications: hepatitis (1), malignant hyperthermia (10), and cardiac arrhythmias (4).
• No deaths or permanent sequelae were reported in any child.
• Eleven cases involved possible contributions from other drugs like succinylcholine, atropine, cocaine, and epinephrine.

Conclusions:

• Halothane appears to be a safe anesthetic agent for pediatric use with a low incidence of severe adverse events.
• Malignant hyperthermia was the most frequent serious complication associated with halothane anesthesia in this cohort.
• Concurrent administration of other drugs may increase the risk of adverse reactions during halothane anesthesia.