Clinical observations on fluothane anaesthesia

Conclusions

Fluothane has been used for anaesthesia in 1,112 surgical cases. No fatalities have occurred either during surgery or during fifteen days after the operation. Déath occurred in three patients with cancer and in one with spinal trauma at a late postoperative date. Any reasonable connection with the anaesthetic can be disregarded.

• 1. Male, 53 years of age Fracture of L1-L2, section of terminal cord, intestinal and bladder disorders November 18, 1956 Laminectomy Anaesthetics Pentothal 325 mg, Flaxedil 60 mg, N₂O-O₂-Fluothane December 3, 1956 15 days later, bronchopneumonia December 3–4, 1956 Bronchial aspiration December 4, 1956 Patient died, 16 days after operation Terminal bronchopneumonia

• 2. Male, 47 years of age Rectal neoplasm dating back to January, 1956 February 8, 1957 Artificial anus Anaesthetics N₂O-O₂-Fluothane, Flaxedil 20 mg February 21, 1957. Second operation Anaesthesia without Fluothane March 5, 1957. Patient died, 25 days after anaesthesia with Fluothane Generalized metastases

• 3. Female, 48 years of age Bladder neoplasm November 28, 1956 Removal of bladder clots Anaesthetic N₂O-O₂-Fluothane January 21, 1957 Patient died, 54 days after anaesthesia Metastases

• 4. Male, 75 years of age Achromic melanoma December 4, 1956. Cystostomy Anaesthetics Neraval 625 mg, N₂O-O₂-Fluothane February 3, 1957. Patient died, 61 days after anaesthesia with Fluothane Cerebral metastases

The following conclusions may be drawn from this study of 1,112 cases of anaesthesia with Fluothane:

Fluothane has many advantages. Its disadvantages are easily controlled. It is a potent, volatile anaesthetic, its action is easily reversible, it is non-explosive and non-inflammable (it can even put out a flame). It produces smooth and easy induction, and is well tolerated by the patient. Induction should be slow, gradual and progressive. The patient should be maintained quietly without hyperventilation and without sudden increases in concentration; a properly calibrated vaporizer should be used. This is the best way to avoid a sudden hypotension, cardiac arrhythmias and respiratory depression which this anaesthetic may produce (7).

The fact that there is no broncho-constriction and no laryngospasm, and that tracheo-bronchial secretions are diminished, facilitates pulmonary ventilation and contributes somewhat to less postoperative pulmonary atelectasis. Fluothane may be used with soda lime It decreases capillary oozing and blood loss during surgery. It appears to have anti-shock activity, in the manner of the “ganglioplegic” agents. It has a mild postoperative ataraxic effect. Clinically, it seems to be non-toxic; there are no urinary disorders, fatigue or anorexia.

Possibly Fluothane is the equal of ether and cyclopropane, but has advantages which are lacking in both these agents: non-explosibility, non-inflammability, inhibition of tracheo-bronchial secretions, anti-shock, potency, and easy reversibility.