Bromochlorotrifluoroethane

Uses

Bromochlorotrifluoroethane is a volatile anaesthetic which is suitable for the induction and maintenance of anaesthesia for all types of surgery and in patients of all ages.

Bromochlorotrifluoroethane is also used to associated treatment for these conditions: Anaesthesia therapy

How Bromochlorotrifluoroethane works

Bromochlorotrifluoroethane causes general anaethesia due to its actions on multiple ion channels, which ultimately depresses nerve conduction, breathing, cardiac contractility. Its immobilizing effects have been attributed to its binding to potassium channels in cholinergic neurons. Bromochlorotrifluoroethane's effect are also likely due to binding to NMDA and calcium channels, causing hyperpolarization.

Dosage

Bromochlorotrifluoroethane dosage

A number of anaesthetic vaporisers specially designed for use with Bromochlorotrifluoroethane are available. Open, semi-open, semi-closed and closed circuit systems have all been used with good results.

For induction of anaesthesia:

• Adult: A concentration of 2-4% Bromochlorotrifluoroethane in Oxygen or Nitrous Oxide may be used.
• Children: A concentration of 1.5-2% Bromochlorotrifluoroethane in Oxygen or Nitrous Oxide is used.

For maintenance of anaesthesia:

• Adults and children: A concentration of 0.5-2% is usually required for maintenance of anaesthesia. The lower concentration is usually most suitable for elderly patients.

Side Effects

Post-op nausea, vomiting, and shivering; resp depression, hypotension, skeletal muscle relaxation, bradycardia.

Toxicity

Toxic effects of halothane include malignant hyperthermia and hepatitis.

Precaution

Caution should be exercised during administration of adrenaline to patients anaesthetised with Bromochlorotrifluoroethane as dysrhythmias may be precipitated. For this reason the dose of adrenaline should be restricted and beta-receptor antagonists administered if necessary. Ensure adequate room ventilation when Bromochlorotrifluoroethane is being used. Keep the concentration of Bromochlorotrifluoroethane in air as low as possible.

Effect on ability to drive or operate machinery: Patients should be advised that performance at skilled tasks, such as driving and operating machinery, may be impaired for some time after general anaesthesia.

Accidental ingestion: Cases of ingestion must be treated symptomatically.

Interaction

Increased risk of ventricular dysrhythmias with epinephrine. Increased risk of malignant hyperthermia with suxamethonium. Prolonged recovery from anaesth with concurrent use of ketamine for induction. May potentiate response to non-depolarising muscle relaxants, hypotensive agents (e.g. hexamethonium bromide, trimetaphan camsilate).

Food Interaction

Bromochlorotrifluoroethane Drug Interaction

Unknown: aspirin, aspirin, dexamethasone, dexamethasone, dextran, low molecular weight, dextran, low molecular weight, ginkgo, ginkgo, acetaminophen, acetaminophen, cyanocobalamin, cyanocobalamin, riboflavin, riboflavin, pyridoxine, pyridoxine, ascorbic acid, ascorbic acid, phytonadione, phytonadione

Bromochlorotrifluoroethane Disease Interaction

Moderate: cardiovascular dysfunction

Pregnancy & Breastfeeding use

Category C: Although the data from experimental investigations in animals cannot be directly related to man, it would be prudent to avoid general anaesthesia with inhalation agents during early pregnancy, except where such use is essential.

Lactation: There are no well controlled studies with Bromochlorotrifluoroethane in lactating women. Bromochlorotrifluoroethane has been detected in breast milk of lactating women, but the effect of Bromochlorotrifluoroethane on breast feed neonates has not been established. However, Bromochlorotrifluoroethane has been in wide use for over 30 years without apparent ill consequence

Contraindication

Bromochlorotrifluoroethane can induce liver damage; however, the incidence of severe liver damage (jaundice, which may lead to hepatic failure as a consequence of massive hepatic cell necrosis) is unknown. The risk of developing hepatic failure appears to be increased by repeated exposure. Although short intervals of time between exposures are likely to increase the risk of hepatotoxicity, even long intervals between exposures maynot eliminate the risks, since some patients have developed severe reactions following Bromochlorotrifluoroethane given many years after the previous exposures. On the information which is available at the present time, it is advised that the followingprecautions be taken

• A careful anaesthetic history should be taken prior to use, to determine previous exposure and previous reactions following Bromochlorotrifluoroethane anaesthesia.
• Repeated exposure to Bromochlorotrifluoroethane within a period of at least 3 months should be avoided unless there are overriding clinical circumstances.
• History of unexplained jaundice and pyrexia in a patient following exposure to
• Bromochlorotrifluoroethane is a contraindication to its future use in that patient unless absolutely essential.
• Patients should be informed if they have developed a reaction possibly related to Bromochlorotrifluoroethane anaesthesia; such patients should be provided with a medical alert card stating the problem.

Storage Condition

Bottles of Bromochlorotrifluoroethane must be securely closed and stored in a cool dry place, protected from light. Bromochlorotrifluoroethane must be kept in the original container until immediately prior to its use.

Whilst in the liquid phase, Bromochlorotrifluoroethane must not be diluted or contaminated; however, in the vapour phase it may be administered together with Oxygen or a mixture of Nitrous Oxide and Oxygen.

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