title: Halothane: how should it be used in a developing country?
abstract: The anaesthetic agent halothane is still widely used in developing countries including the Islamic Republic of Iran because of its low price. Because of halothane-induced hepatitis, a rare complication, it has been replaced by other inhalation anaesthetics in Western countries; it has been suggested by some Iranian professionals that the Islamic Republic of Iran should do the same. We evaluated various dimensions of this replacement through a literature review to assess the incidence of halothane-induced hepatitis and costs of anaesthetics in the country. We also conducted a questionnaire survey of 30 anaesthesiology/gastroenterology experts about their views on the subject. The results indicate that the incidence of halothane hepatitis in the Islamic Republic of Iran is very low and could mostly be avoided by strict adherence to guidelines. Complete withdrawal of halothane in the Islamic Republic of Iran might not be appropriate at present. Comprehensive cost-effectiveness studies are needed before a decision is made on complete replacement of halothane with other anaesthetics.
authors.affiliation: Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: N
authors.initials: N
authors.lastname: Mahboobi
authors.forename: S
authors.initials: S
authors.lastname: Esmaeili
authors.forename: S
authors.initials: S
authors.lastname: Safari
authors.forename: P
authors.initials: P
authors.lastname: Habibollahi
authors.forename: A
authors.initials: A
authors.lastname: Dabbagh
authors.forename: S M
authors.initials: SM
authors.lastname: Alavian
mesh_terms: D018685:Anesthetics, Inhalation / Q000009:adverse effects / Q000191:economics / Q000592:standards; D001291:Attitude of Health Personnel; D056486:Chemical and Drug Induced Liver Injury; D003365:Costs and Cost Analysis; D000077335:Desflurane; D003906:Developing Countries / Q000191:economics; D006221:Halothane / Q000009:adverse effects / Q000191:economics / Q000592:standards; D006801:Humans; D007492:Iran; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives / Q000191:economics / Q000592:standards; D008738:Methyl Ethers / Q000009:adverse effects / Q000191:economics / Q000592:standards; D018570:Risk Assessment; D000077149:Sevoflurane; D011795:Surveys and Questionnaires
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D006221:Halothane