Bangladesh orders safer anaesthesia alternatives after circumcision deaths

It recommends using isoflurane and sevoflurane instead of halothane as inhalation anaesthetics in all public and private hospitals nationwide

The health ministry has directed hospitals to use isoflurane or sevoflurane as anesthetics for patients undergoing surgery, replacing halothane.

The Health Services Division issued a notification on Wednesday directing the Directorate General of Health Services, the Directorate General of Drug Administration, and other health authorities to take steps to prevent anaesthesia-related deaths and misuse.

Recently, two children died after receiving anaesthesia for circumcision. Their deaths have raised concerns about the administration of the drug in the country.

Ahnaf Tahmin Ayham, 10, was taken to JS Diagnostic and Medical Check-up Centre in Dhaka's Malibagh for circumcision by his family but died after the procedure.

Previously, on Dec 31, 5-year-old Ayan Ahmed suffered the same fate after being admitted to United Medical College for a circumcision procedure. However, he did not regain consciousness after being administered anaesthesia.

Ayan was subsequently transferred to United Hospital in Gulshan and placed on life support. He died on Jan 7.

According to the notification, it is recommended to use isoflurane and sevoflurane instead of halothane as inhalation anaesthetics in all public and private hospitals nationwide.

Furthermore, the notification emphasises the importance of preventing the sale and unauthorised use of halothane without approval from the drug administration authority.

Prof Dr Debabrata Banik, the president of the Bangladesh Society of Anaesthesiologists, Critical Care, and Pain Physicians, told bdnews24.com that halothane, isoflurane, and sevoflurane are essentially the same drugs. However, halothane was used more because it was a bit cheaper.

"We've been using halothane for 40 years. But now, the suppliers aren't providing it anymore. Instead, traders are illegally importing it from abroad.

“They're selling medicines worth Tk 1,300 for Tk 5,000 by mixing them with other substances. That's why we suggest stopping the use of this drug. Instead, we can use the alternatives available in the market."