(1989; 60 pages) [French]
Group: volatile inhalational anaesthetic agent
Trichloroethylene is a colourless slightly volatile liquid with a sweet smell. It is normally artificially coloured blue for ready identification.
Trichloroethylene is non-flammable and cheap. It has a strong analgesic effect; it does not irritate the respiratory tract and does not promote capillary oozing.
The hypnotic effect is weaker than that of other commonly used volatile inhalational agents. Trichloroethylene must generally be used with other inhalational agents and muscle relaxants to produce a state of full surgical anaesthesia. Breathing can become very rapid and shallow. Trichloroethylene must never be used in a closed-circuit system with soda lime since it is then converted into toxic compounds. Epinephrine should generally not be used concurrently since it increases the danger of dysrhythmias.
• Maintenance of light anaesthesia.
• To supplement nitrous oxide-oxygen or halothane anaesthesia during major surgery.
• In subanaesthetic doses, to provide analgesia for obstetrics, emergency treatment of traumatic injury, and other acutely painful conditions.
Dosage and administration
Trichloroethylene may be used alone, with halothane in a draw-over apparatus, or with nitrous oxide and oxygen in a continuous-flow anaesthetic machine.
It is preferably administered from a calibrated vaporizer. To avoid oxidation a fresh supply of trichloroethylene should be placed in the vaporizer every few days; unused anaesthetic should be discarded.
In general, trichloroethylene is used in concentrations of 0.5-1.5% to maintain light anaesthesia and 0.35-0.5% as an analgesic.
Recovery time is slow after prolonged administration. Trichloroethylene is consequently used at low vapour concentrations to maintain anaesthesia and it is preferably withdrawn some 20 minutes before the end of the surgical intervention.
• Raised cerebrospinal fluid pressure.
Prolonged tachypnoea can result in carbon dioxide retention and hypoxia, which predispose the patient to cardiac dysrhythmias. Tachypnoea can often be averted by reducing the inspired concentration of vapour. Otherwise, ventilation must be controlled or pethidine 25 mg administered intravenously.
Dysrhythmias occasionally necessitate the administration of a β-adrenoceptor-blocking agent such as propranolol.
Epinephrine should not be used concurrently with trichloroethylene since it increases the risk of ventricular dysrhythmias.
Use in pregnancy
Trichloroethylene should be used in pre-term pregnancy only when the need outweighs any possible risk to the fetus. It is widely used as an analgesic in obstetric practice.
Postoperative nausea, vomiting and headache occasionally occur. Tachypnoea and cardiac dysrhythmias are dose-related. Cardiorespiratory depression occurs with the doses of trichloroethylene needed to produce deep anaesthesia.
Trichloroethylene should be stored in well-closed containers protected from light, below 25°C. Thymol (100 micrograms/ml) is added to commercial supplies as a stabilizing agent. Waxoline blue (5 micrograms/ml) is also added for identification purposes.