General anaesthetics enflurane

H58. Hussey, A. J., Aldridge, L. M., Paul, D., Ray, D. C., Beckett, G. J., and Allan, L. G., Plasma glutathione S-transferase concentration as a measure of hepatocellular integrity following a single general anaesthetic with halothane, enflurane or isoflurane. Br. J. Anaesth. 60,130-135... 

Interestingly, anticholinesterases, ACH and ion antagonize competitively pancuronium bromide effectively however, its activity is virtually enhanced by general anaesthetics, for instance halothane, ether, enflurane etc. (see Chapter 4). Therefore, the latter substantial potentiation in pharmacological activity is particularly useful to the anaesthetist due to the faet that it is administered invariably as an adjunct to the anaesthetic procedure in order to cause simultaneous relaxation of the skeletal muscle. 

In the 1980s two more anaesthetics came into use enflurane and isoflurane. These were not metabolised by the liver to the same extent, 2% in the case of enflurane, and only 0.2% of isoflurane. Enflurane was introduced into clinical use in 1981, but isoflurane was delayed because some research appeared to show that it caused liver cancer in mice. This research was repeated by others and shown to be wrong and isoflurane came into general use in 1984. What operating theatre personnel did not like was its off-putting smell. Were there health risks associated with the new anaesthetics A statistical analysis of the side-effects experienced by 17,201 patients on whom they were used was compared with the effects experienced by a similar group on whom halothane had been used. Patients on the newer anaesthetics were more likely to suffer a heart attack and, with isoflurane, palpitations were more common. However, there was no increased risk of the patient dying. 

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