title: The role of inhalational anesthetic drugs in patients with hepatic dysfunction: a review article.
abstract: BACKGROUND
  Anesthetic drugs including halogenated anesthetics have been common for many years. Consequent hepatic injury has been reported in the literature. The mechanism of injury is immunoallergic. The first generation drug was halothane; it had the most toxicity when compared to other drugs. The issue becomes more important when the patient has an underlying hepatic dysfunction.
  
  
  METHODS
  In this paper, reputable internet databases from 1957-2014 were analyzed and 43 original articles, 3 case reports, and 3 books were studied. A search was performed based on the following keywords: inhalational anesthesia, hepatic dysfunction, halogenated anesthetics, general anesthesia in patients with hepatic diseases, and side effects of halogenated anesthetics from reliable databases. Reputable websites like PubMed and Cochrane were used for the searches.
  
  
  RESULTS
  In patients with hepatic dysfunction in addition to hepatic system and dramatic hemostatic dysfunction, dysfunction of cardiovascular, renal, respiratory, gastrointestinal, and central nervous systems may occur. On the other hand, exposure to inhalational halogenated anesthetics may have a negative impact (similar to hepatitis) on all aforementioned systems in addition to direct effects on liver function as well as the effects are more pronounced in halothane.
  
  
  CONCLUSIONS
  Despite the adverse effects of inhalational halogenated anesthetics (especially halothane) on hepatic patients when necessary. The effects on all systems must be considered and the necessary preparations must be provided. These drugs are still used, if necessary, due to the presence of positive effects and advantages mentioned in other studies as well as the adverse effects of other drugs.
authors: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Hassan
authors: H
authors: Soleimanpour
authors: Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran.
authors: Saeid
authors: S
authors: Safari
authors: Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Farzad
authors: F
authors: Rahmani
authors: Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Hoorolnesa
authors: H
authors: Ameli
authors: Hepatitis B Molecular Laboratory, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors: Seyed Moayed
authors: SM
authors: Alavian
keywords: Halothane; Hepatitis; Inhalational Anesthetics