Side effects include irregular heartbeat, respiratory depression, and hepatotoxicity. It appears to be safe in porphyria. It is unclear whether use during pregnancy is harmful to the baby, and it is not generally recommended for use during a C-section.<unk>  is a chiral molecule that is used as a racemic mixture. In rare cases, repeated exposure to<unk>  in adults was noted to result in severe liver injury. This occurred in about one in 10,000 exposures. The resulting syndrome was referred to as<unk>  hepatitis, immunoallergic in origin, and is thought to result from the metabolism of<unk>  to trifluoroacetic acid via oxidative reactions in the liver. About 20% of inhaled<unk>  is metabolized by the liver and these products are excreted in the urine. The hepatitis syndrome had a mortality rate of 30% to 70%. Concern for hepatitis resulted in a dramatic reduction in the use of<unk>  for adults and it was replaced in the 1980s by enflurane and isoflurane. By 2005, the most common volatile anesthetics used were isoflurane, sevoflurane, and desflurane. Since the risk of<unk>  hepatitis in children was substantially lower than in adults,<unk>  continued to be used in pediatrics in the 1990s as it was especially useful for inhalation induction of anaesthesia. However, by 2000, sevoflurane, excellent for inhalation induction, had largely replaced the use of<unk>  in children.<unk>  sensitises the heart to catecholamines, so it is liable to cause cardiac arrhythmia, occasionally fatal, particularly if hypercapnia has been allowed to develop. This seems to be especially problematic in dental anaesthesia. Like all the potent inhalational anaesthetic agents, it is a potent trigger for malignant hyperthermia. Similarly, in common with the other potent inhalational agents, it relaxes uterine smooth muscle and this may increase blood loss during delivery or termination of pregnancy. Occupational safety People can be exposed to<unk>  in the workplace by breathing it in as waste anaesthetic gas, skin contact, eye contact, or swallowing it. The National Institute for Occupational Safety and Health (NIOSH) has set a recommended exposure limit (REL) of 2 ppm (16.2 mg/m3) over 60 minutes.
Halothane
Isoflurane
Methoxyflurane
Desflurane
Sevoflurane
Etomidate
Methitural
Ketamine