The National Halothane Study and Hospital Outcomes

The National Halothane Study: A Study of the Association Between Halothane Anesthesia and Postoperative Hepatic Necrosis. Report of the Subcommittee on the National Halothane Study, Committee on Anesthesia, Division of Medical Sciences, National Academy of Sciences-National Research Council. By Bunker JP, Forrest WH, Mosteller FJ, and Vandam LD. Bethesda, Maryland, National Institutes of Health, 1969. Halothane, a potent nonflammable inhalational anesthetic, was introduced into clinical practice in the United Kingdom in 1956 and the United States in 1958. Shortly after its release for use, isolated published reports appeared of fatal postoperative hepatic necrosis in patients who had received halothane during surgery. "Halothane hepatitis" became a clinical diagnosis, although no studies had confirmed halothane as the actual cause of liver failure. The Public Health Service's National Research Council (Washington, D.C.), the operating arm of the National Academy of Sciences, decided to sponsor a study to determine whether halothane hepatitis was an actual clinical entity. They contacted John P. Bunker, M.D., a National Academy of Sciences member and chair of the Department of Anesthesia at the Stanford University School of Medicine (Stanford, California), to study the question. Bunker asked a new postgraduate research fellow, William H. Forrest, Jr., M.D., to design, organize, and manage a study to determine whether exposure to halothane caused hepatic failure.