Question

Explain the following:

Chloroform is not used as an anaesthetic nowadays.

Answer 1

1. Chloroform strongly depresses respiration, making ventilatory control during anaesthesia hazardous.
2. It sensitises the myocardium to catecholamines and can cause sudden fatal arrhythmias (ventricular fibrillation) even at doses that otherwise seem adequate.
3. Metabolism of chloroform (via liver enzymes) produces reactive intermediates (e.g., trichloromethyl-type species and related products) that cause hepatotoxicity and can injure the kidneys.
4. The margin between an effective anaesthetic dose and a harmful dose is small (narrow therapeutic index), so small dosing errors or individual variability can be lethal.
5. Chronic and occupational exposure raised long-term safety concerns (toxic and possibly carcinogenic effects).
6. Modern anaesthetic agents (inhalational and intravenous) provide more predictable depth control, less cardiotoxicity and lower organ toxicity, so they have replaced chloroform in clinical practice.