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Ann Thorac Surg 1980;29:123-129
© 1980 The Society of Thoracic Surgeons

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Articles

Improved Anesthesia for Deep Surface-Induced Hypothermia: The Halothane-Diethyl Ether Azeotrope

Division of Cardiothoracic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA

Accepted for publication April 2, 1979.

^* Address reprint requests to Dr. Dillard, Division of Cardiothoracic Surgery, Department of Surgery, University of Washington School of Medicine, BB 438, RF-25, Seattle, WA 97195

The halothane-diethyl ether azeotrope was evaluated in dogs as the anesthetic agent for deep surface hypothermia with total circulatory arrest for open-heart operation. All 10 animals given azeotrope in 100% oxygen (O₂) experienced atrial arrhythmias during cooling, and 1 had ventricular fibrillation prior to the completion of cooling at 18° to 20°C. After only 30 minutes' arrest, 8 of the 10 dogs had postoperative motor disturbances. Administering the azeotrope in 95% O₂ and 5% carbon dioxide (CO₂) yielded markedly improved results characterized by a rapid, smooth cooling course, easy resuscitation following circulatory arrest, and rapid rewarming, and 3 out of 10 dogs experienced mild motor disturbance after 60 minutes of circulatory arrest.

This method, when compared with our standard method of ether in 100% O₂, resulted in reduced blood lactates and a striking improvement in clinical status on the first postoperative morning. In limited clinical trials, infants undergoing repair of congenital cardiac defects have done well and responded as expected based on the laboratory experience. Since the results with the azeotrope in 95% O₂ and 5% CO₂ were at least as good as, and in several instances better than, those with the standard method employing ether, the nonexplosive characteristic of the azeotrope warrants continued evaluation of this agent.

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