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Canadian Journal of Anesthesia, Vol 31, 279-286, Copyright © 1984 by Canadian Anesthesiologists' Society

Review Articles: Viral Hepatitis and the Anaesthetist

RONALD A. BROWNE MD FRCP(C)1 and MAX A. CHERNESKY PHD1

1 Departments of Anaesthesia, Pediatrics and Pathology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada

Address correspondence to: Dr. R.A. Browne, Department of Anaesthesia, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2.

Viral hepatitis is a constant hazard to all operating room personnel. The anaesthetist should avoid contact with patients' blood and saliva as much as is possible.

Hepatitis A (HAV) is spread mainly by faecal/oral contact. Carriers are almost non-existent in this disease and the main importance to the anaesthetist is that he may contact a patient who is acutely infected or one who is incubating HAV. Diagnosis of postoperative hepatic dysfunction may then be a problem. Prophylaxis with Gamma globulin is also stressed.

Hepatitis B(HBV) and Non-A Non-B hepatitis (NANB) have a high incidence of carriage, and are spread mainly by blood contact. The groups of patients whom the anaesthetist should especially be aware of are reviewed, as is prophylaxis using Hepatitis B Immune Globulin and the recently introduced Hepatitis B vaccine. NANB continues to be a diagnostic problem, its diagnosis being mainly by exclusion of other causes of viral hepatitis. It appears to be responsible for more than 90 per cent of cases of posttransfusion hepatitis and more than one virus may be involved.

Key Words: LIVER: viral hepatitis, hepatitis A, hepatitis B, hepatitis Non-A Non-B • OCCUPATIONAL HAZARDS: hepatitis






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Copyright © 1984 by the Canadian Anesthesiologists' Society.